PRIVATE BUSINESS

St. Austell Market Bill

Considered; to be read the Third time.

Oral Answers to Questions

SCOTLAND

The Secretary of State was asked—

Identity Cards

Greg Hands: What discussions he has had with the First Minister on the implementation of the identity card scheme in Scotland.

Des Browne: With your permission, Mr. Speaker, may I take the opportunity before I answer the question to wish all hon. Members a happy St. George's day? I know that I am here to answer questions, but may I ask my English colleagues why they do not make more of William Shakespeare's birthday?
	With regard to the hon. Gentleman's question, although I have had no such discussions, I have regular discussions with the First Minister on a range of issues. I look forward to further constructive discussions in the interests of the people of Scotland.

Greg Hands: May I echo the Secretary of State's sentiments on St. George's day?
	The Secretary of State will know that the next Conservative Government are pledged to abolish identity cards anyway, so any discussion held now might become rather academic. He knows that the Scottish Executive are pledged to obstruct the implementation of ID cards in Scotland. Does he not realise that non-implementation in Scotland would fatally undermine any identity cards system throughout the UK?

Des Browne: The hon. Gentleman aspires to a Government with a policy to abandon the scheme. However, I venture to suggest that the necessity for secure and reliable proof of identity, which will continue, requires the Government to respond to the desire of the people of the United Kingdom. As presently measured, the idea attracts support from more than 60 per cent. of the population. The Scottish Executive will not be able to obstruct the introduction of the identity cards scheme throughout the United Kingdom. If they, as providers of devolved services, choose not to avail themselves of the opportunities that the scheme allows to assert the identity of those who seek public services, that is entirely a matter for them. That is what devolution is all about.

Eric Joyce: When it comes to tackling terrorism and providing security in this country, does my right hon. Friend agree that ID cards have a part to play? Such things should be dealt with at the UK level, contrary to what that bunch diametrically opposite suggest. Their suggestion that they should be dealt with in Scotland is, at best, a dangerous distraction.

Des Browne: My hon. Friend is quite right. The evidence is overwhelming that those who have been convicted of terrorism—during the past year, a significant number have been convicted beyond reasonable doubt in our courts—almost invariably use multiple identities to advance their horrific objectives. There is no question but that a secure and reliable system of identity that fixes the identity of a person through biometrics will assist in dealing with terrorism, and everyone involved in policing terrorism confirms that that is the case. Many quotations from those charged with that responsibility express the idea that one of the most important things we could do to assist in that task is set up an identity card scheme underpinned by biometric identity. Moreover, 71 per cent. of the people of the UK agree with that, because they understand its importance in our fight against terrorists.

Pete Wishart: When the right hon. Gentleman does have that discussion with the First Minister, he will clearly learn that the people of Scotland do not want ID cards. The Scottish Parliament has voted against the introduction of ID cards, and they will not be required for Scottish Government services. Will he assure me that there will be no attempt to introduce ID cards in Scotland through the back door—by targeting students' bank accounts and loans, for example?

Des Browne: For the bulk of the things that matter to the people of Scotland, this House is the front door. As far as security of their identity is concerned, the people of Scotland are in no different a position from the rest of the United Kingdom, or indeed, I venture to suggest, no different a position from the hon. Gentleman. If he were to open his wallet today, I suspect he would find many proofs of his identity. If that identity were underpinned by a biometric database, he would be secured against others seizing that identity and abusing it. We will deliver that for the people of Scotland. We will roll it out incrementally, and they will welcome it and use it voluntarily much more than he would wish them to.

Jim Sheridan: My right hon. Friend will be aware of the genuine concerns that the public have expressed about the increasing amount of fraud. When he meets the First Minister to discuss the implementation of identity cards, will he explain its benefits for reducing fraud?

Des Browne: On a day when we probably all woke to the announcement of the publication of yet another report that shows the amount of identity fraud through credit cards and the cost to the United Kingdom, there is no question but that we need to move to the same position as 24 out of 27 of the countries in the European Union and have identity cards. Those countries do not have oppressive regimes. Indeed, in many respects, the current Administration in Scotland look to them with envy. They are social democratic regimes that have moved to identity cards because they help people to protect their identity, especially against the sort of fraud that is perpetrated daily.

Ben Wallace: One aspect of the Government's identity card scheme is that everyone, of any age, will have to travel to one of only 11 biometric centres in Scotland. For some people who do not live close to the centres, that means long and expensive journeys to get their identity protected. Of course, the Secretary of State knows all about identity theft, having stolen one from the Secretary of State for Defence. Is not it absurd that the Government solution to counter-terrorism is that 80-year-olds in Pitlochry will have make 100 mile round trips to get their data scanned, while people in England have to have an identity card to get the services that they need?

Des Browne: I will speak to the hon. Gentleman afterwards so that he can explain the joke, because I do not believe that any of us got it.
	The hon. Gentleman and his party support a passport system, which is underpinned by biometrics. That is his party's policy. Eventually, every adult who has a passport in this country—that is a significant number of adults of all ages—will have to go through exactly that process. That is why we have developed a network of offices, which will be expanded if necessary. There currently are nine throughout Scotland. The journeys that people must make to have their biometrics secured are no different from those that he would continue to impose on them through supporting the policy on biometric passports. The criticism is nonsense and he knows it.

Glaxo SmithKline

Brian H Donohoe: What representations he has received on assisting staff made redundant at Glaxo SmithKline's operation in Central Ayrshire constituency.

Des Browne: I have received no representations on assisting staff that may be made redundant at Glaxo SmithKline's operation in Irvine. However, I expect at least some of my constituents to be in that category, so I also expect representations to be made to me as a constituency Member of Parliament, if for no other reason. Clearly, it is a worrying time for those concerned and I extend my sympathies to them.

Brian H Donohoe: I thank my right hon. Friend for that reply. I am the local Member of Parliament, and as my neighbouring Member of Parliament he will remember the redundancies at a nearby company called Simclar. Jobcentre Plus had enormous success in getting almost every employee a job. Since some of my right hon. Friend's constituents are affected, will he consider approaching Jobcentre Plus and asking it to become involved in the current case?

Des Browne: As I know the detail of what my hon. Friend consistently does for his constituents, I pay tribute to him for his support. The closure to which he referred had a devastating effect on several people, and they were ably assisted by his involvement. He will be pleased to know that Jobcentre Plus is slightly ahead of him. It leads on what is called Partnership Action for Continuing Employment—PACE—in Central Ayrshire. Indeed, it was in touch with Glaxo SmithKline on 2 April—the day after the announcement of the consultation. I understand that Glaxo SmithKline will meet the PACE manager shortly—in the next two or three weeks—and I am sure that Jobcentre Plus and the PACE scheme, which goes beyond it, will have success similar to that that they have consistently had in the past in placing people in training or new jobs.

Electoral Administration

Chris Ruane: What recent discussions he has had with the First Minister on the organisation of elections in Scotland.

David Cairns: The Secretary of State met the First Minister on 25 January, when they discussed several issues, including the organisation of elections in Scotland.

Chris Ruane: I thank the Minister for that reply. I also congratulate him on the work that he did on electoral administration as a Minister in the Department for Constitutional Affairs. Progress has been made on registration; indeed, there are an extra 500,000 people on the electoral register. Progress has been mixed across the UK. In my constituency we have an extra 5,000 people on the register. What actions can the Minister take in Scotland against recalcitrant EROs—electoral registration officers—who do not take their work seriously, do not think that people should be registered to vote and have not taken up the powers that he has given them to do the job?

David Cairns: My hon. Friend has done more than any other Member of the House to raise the issue of under-registration of voters. The progress made in the past couple of years is in no small measure due to his efforts. Following the passage of the Electoral Administration Act 2006, I wrote to registration officers in Scotland, in February 2007 and again in August 2007, pointing out their new duties under the Act and asking what progress had been made. I tell my hon. Friend in all candour that I am disappointed with the progress that has been made. We might have to revisit the issue in the light of any reforms that follow the recommendations of the Gould report.

Willie Rennie: Would the organisation of elections in Scotland not be made much simpler if we adopted the same voting system for all elections in Scotland and throughout the UK? Would the best system not be the single transferable vote by proportional representation, which was agreed by the Minister's party and mine when we were friends together in the Scottish Executive?

David Cairns: I agree with the hon. Gentleman to the extent that things would be much easier if there were one system for all elections, and if that system were first past the post.

Gavin Strang: Having the privilege of representing the constituency that, sadly, had the highest number of spoilt ballot papers last May, can I urge my hon. Friend to continue working constructively on the follow-through to the Gould report? In particular, does he agree that it is vital to decouple the Scottish Parliament elections from the Scottish local government elections? That would completely eliminate the need for a joint ballot paper. Obviously these are matters for the Scottish Administration, too, but may I also suggest that he give careful consideration to the recommendation of the Convention of Scottish Local Authorities that the Scottish local government elections be held a year after the Scottish Parliament elections?

David Cairns: As my right hon. Friend knows, that issue is currently out to consultation by the Administration in Scotland. Their preferred option would be to decouple the elections and to have the local council elections a year later, as he suggested, which is one of the options in the consultation. It is important to send the people of Scotland a clear signal today that what occurred on 3 May last year will not happen again, that we will not see a repeat of the confusion that led to the unacceptable number of spoilt papers again, and that steps have been taken by the Government and will be taken in due course by the Scottish Administration to restore people's confidence in the integrity of the electoral system.

Mr. Speaker: I call Angus MacNeil.

Angus MacNeil: Thank you, Mr. Speaker, and happy St. George's day. Is the Electoral Reform Society right or wrong when it says that it would be an "affront to democracy" if Westminster controlled the Scottish elections?

David Cairns: No, I do not agree. One of the most disappointing aspects of the debate has been the consistent misrepresentation of what Mr. Gould actually believes. I remind the hon. Gentleman of what Mr. Gould told him about devolution when he gave evidence in this place:
	"This was...raised in the context of a chief returning officer. The concept here was that if there is going to be accountability there needs to be a point of focus...The recommendation that the jurisdictional responsibility for that management of the election be located in Scotland...so it is a management process here...if the legislation remains in Westminster for the parliamentary elections that is fine".
	That is what Mr. Gould said, and the hon. Gentleman's party should stop misrepresenting him.

Electricity Generation

Anne Moffat: What estimate he has made of the proportion of electricity generation capacity in Scotland that is (a) renewable, (b) fossil fuel and (c) nuclear.

David Cairns: The Royal Society of Edinburgh's "Inquiry into Energy Issues for Scotland" found that, over time, 8 to 10 per cent. of Scotland's electricity comes from distributed hydroelectric stations, 33 to 35 per cent. comes from coal, 16 to 18 per cent. comes from gas and 38 to 40 per cent. comes from nuclear. Those proportions will, of course, vary owing to factors such as increased development of onshore wind and planned maintenance closures of power stations.

Anne Moffat: I thank my hon. Friend for that answer. Does he share my concern, and that of the Scottish TUC and the Unite union, about a balanced energy policy? We must live in the real world, not in the world of the nationalists, who think that they can run the energy supply only on renewables—laudable though those renewables are. Does my hon. Friend agree that we need a mix that includes nuclear power that is home grown and not bought in from other countries?

David Cairns: My hon. Friend is right to focus the debate on the issue of Scotland's base load—in other words, the electricity that we need seven days a week, 52 weeks a year, irrespective of whether the wind is blowing or the waves are crashing. We know that the Scottish National party is against nuclear; we also know that it is against wind farms in its own constituencies. What we do not know is how it is going to provide Scotland's base load electricity and keep the lights on. It is time that we were told.

Michael Moore: Regardless of how Scotland's electricity supply is produced, people across the country are facing massively increased fuel bills. That is particularly true in rural areas. Will the Minister therefore explain how the abolition of the 10p rate of income tax is going to help with the Government's stated aim of abolishing fuel poverty?

David Cairns: I first welcome the hon. Gentleman to his promotion to shadow Secretary of State for Scotland. I can see looks of great relief on the faces of some of those sitting behind him that he has accepted the post. What has happened to fuel costs is a global phenomenon. A few years ago, the price of a barrel of oil was $10; today it is $117. Of course that puts pressure on the tremendous inroads that we have made in reducing fuel poverty. That is why the Chancellor of the Exchequer and Treasury Ministers met the fuel companies to discuss the extension of social tariffs, and why we have increased the winter fuel payment, which is now worth considerably more than any previous scheme. We have done that precisely to help people who are facing rising fuel bills, and we will continue to take action because we believe that fuel poverty is a genuine social evil that has to be combated.

David Hamilton: May I merely make the point to my hon. Friend that we are sitting on millions of tonnes of coal in Scotland? If we are talking about increasing oil and gas prices, surely we should also be talking about an expansion of the coal industry and clean coal technology. We should be exploiting and pushing that in Scotland.

David Cairns: My hon. Friend is a long-standing advocate and proponent of the coal industry in Scotland, and he is quite right. Let me refer him back to my original answer and remind him that 33 to 35 per cent. of Scotland's electricity comes from coal-fired power stations, so coal has to play a part in the balanced energy mix. Clean coal technology is being pioneered in Scotland by Doosan Babcock, Clyde Blowers and others, and Scottish companies are also playing their part in the carbon capture and storage competition that is being run at the moment. I entirely agree with my hon. Friend that coal has an important part to play in the future.

David Mundell: The Minister will be aware that the availability of fossil fuels for electricity generation and other purposes is a major concern in Scotland, given the potential shutdown of the Grangemouth refinery. Will the Minister tell us what role the UK Government are playing in seeking a resolution to this matter, and will he update the House on the current position? Can he also offer business and private motorists in Scotland a reassurance that contingency arrangements are in hand to ensure that there will be no threat to fuel supplies, and that the panic buying and stocking up of petrol is therefore completely unwarranted?

David Cairns: My right hon. Friend the Secretary of State has been in regular contact with the Secretary of State for Business, Enterprise and Regulatory Reform over the past few days, and they have made it clear that by far and away the best solution will be a negotiated solution between the management and the trade unions. The hon. Gentleman will be aware that such talks are under way, and being facilitated by ACAS. I am happy to offer him the reassurance that contingency plans are in place and that there is no need for motorists to buy more fuel than they would normally buy at this time. Of course, all our focus at present has to be on getting a negotiated settlement.

Ian Davidson: Is the Minister aware that a substantial amount of electricity will be required to manufacture the two new aircraft carriers? Can he tell me—or can he ask a friend—when he expects those orders to be placed?

Mr. Speaker: Order. The Minister can write to the hon. Gentleman about that.

Motorcycling

Alan Reid: What recent discussions he has had with the Driving Standards Agency on test facilities for motorcyclists in Scotland.

David Cairns: Neither I nor the Secretary of State has had any recent discussions with the Driving Standards Agency on test facilities for motorcyclists in Scotland.

Alan Reid: A well intentioned plan to improve training for motorcyclists is backfiring. From September, motorcyclists from Argyll and Bute will have to travel to Glasgow to take their test—a round trip of more than 200 miles for many. A motorcycle school in Oban has already closed as a result and the same thing is happening elsewhere. Will the Government apply the brakes to those new plans for the test centres, review their locations and build such centres in all parts of the country before the new test regime comes into effect? Closed motorcycle schools are not going to help road safety.

David Cairns: I am aware of the concern about this issue in the hon. Gentleman's constituency and elsewhere—and, indeed, in my own constituency. The question of the siting of the new test centres is obviously an issue for the Driving Standards Agency, not for the Government, but it is important that such things are kept under review. Motorcyclists represent 1 per cent. of road traffic users, but have 19 per cent. of fatalities and accidents, so it is in the interests of motorcyclists themselves that standards are raised. That, as the hon. Gentleman says, is the good intention behind the move, as part of a European directive. I take his point that it is important to keep these issues under review. I, for one, would not want to see closures of the training centres of the type that he mentioned.

Angus Robertson: On behalf of the Scottish National party, I wish our friends and neighbours in England a very happy St. George's day and look forward to England's independence.
	The biggest protest against Driving Standards Agency closures took place recently in Moray where more than 700 bikers protested against the DSA's plans to close a testing centre. Does the Minister agree that the safety of bikers, learners and those about to take their test has to be paramount?

David Cairns: I am aware of the issue of the Elgin test centre and of the hon. Gentleman's involvement in the campaign. I saw a photograph of him in the newspaper in motorcycle leathers—at least, I assume they were motorcycle leathers—so I know that he has been part of the campaign. I entirely agree that the safety of motorcyclists has to be the paramount concern, which is, of course, why the new testing regime is being brought in—because motorcyclists are dying on our roads to a hugely disproportionate extent in comparison with their total number. Having said that, I think it important to keep the location of the new test centres under review to ensure that we do not see the closure of the training centres such as has been mentioned, which would clearly not be in anyone's interest.

Scottish Constitutional Commission

Robert Goodwill: Whether he plans to discuss with the Chancellor of the Exchequer the remit of the Scottish constitutional commission on the fiscal powers of the Scottish Parliament.

Des Browne: I meet regularly with my right hon. Friend the Chancellor to discuss a wide range of issues. The hon. Gentleman will, however, wish to note that the remit of the commission is clear: it will put forward recommendations to improve financial accountability to the Scottish Parliament.

Robert Goodwill: The Scottish Executive of course already have the power to introduce road tolls. Does the Secretary of State share my concerns at the threats that have been made to introduce them in a disproportionate way that would threaten the operation of the Faslane nuclear base?

Des Browne: We in government accept our responsibility —our primary responsibility—to ensure the safety and security of this nation, and the strategic deterrent is an important part of securing that. It is our responsibility as the UK Government, and we will not allow anything to interfere with the defence of the United Kingdom.

Tom Clarke: In view of the somewhat imperious decision of the First Minister not to meet me on the issue of the £34 million allocated to disabled children and their families, does my right hon. Friend agree that the Barnett formula is an important issue for discussion, because transparency is clearly of the essence?

Des Browne: We have no plans to review the Barnett formula; indeed, I do not think that any party in this House has any plans to review it. My right hon. Friend is right to desire transparency, and I pay tribute to him for the good work that he has consistently done for disabled people, particularly in securing additional funds from my right hon. Friend the Chancellor of the Exchequer for families with disabled children. The people of Scotland are entitled to know what additional resources will be made available to those families as a result of that extra money. The failure of the Scottish Executive to answer my right hon. Friend's simple questions on these matters will be noted by the people of Scotland, particularly by those families.

David Mundell: Has the Secretary of State discussed with the Chancellor of the Exchequer the exact purpose of his factual paper on the Barnett formula? Given that the formula has been in operation for 30 years, that its details are well known and that the Treasury has not even consulted Lord Barnett about the preparation of the paper, is not the real purpose of the exercise not, as the Prime Minister claims, simply to inform the work of the Scottish constitutional commission, but to serve as the beginning of the review of the Barnett formula for which the Secretary of State for Justice and Labour Back Benchers have been lobbying?

Des Browne: It is nothing of the sort. The purpose of the exercise is exactly as my right hon. Friend the Chancellor of the Exchequer described it: to inform the debate. The hon. Gentleman may know exactly what the Barnett formula is, but the ill-informed debate that constantly rages around the place suggests that many people could do with a refresher course on what it actually is and does.

Prime Minister

The Prime Minister was asked—

Engagements

Louise Ellman: If he will list his official engagements for Wednesday 23 April.

Gordon Brown: Before I list my engagements, let me say that I am sure the whole House will wish to join me in sending profound condolences to the families and friends of Senior Aircraftman Graham Livingstone and Senior Aircraftman Gary Thompson, who were killed in Afghanistan on Sunday 13 April, and Trooper Robert Pearson, who was killed in Afghanistan on Monday 21 April. We owe them, and all others who have lost their lives, a deep debt of gratitude.
	I am also sure that I speak for the whole House when I say how sad we were to learn of the death of Gwyneth Dunwoody. She was a great parliamentarian, and she will be greatly missed from her usual seat in the Chamber. Our thoughts and prayers are with her family.
	This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.

Louise Ellman: While I welcomed the letter from the Chancellor that was published recently, may I ask the Prime Minister to make a specific commitment to introduce, in the current financial year, measures to protect the 5 million people who will be penalised by the abolition of the 10p tax band? Does he agree that such a step would be consistent with the Government's successful policies in combating poverty, making work pay, and moving people from welfare into work?

Gordon Brown: For over a decade, with the minimum wage and child and pension credits, this Government have done more than any Government for a century to tackle child poverty and help low-income families. However, as we have found, there are better ways of helping low-income families than the 10p rate.
	I think I should tell the House that 85 per cent. of the benefits of the 10p rate go to higher-rate and basic-rate taxpayers, and that 11 million people, mainly the lowest-income people in the country, receive no benefit at all from it. That is why we have increased tax credits to tackle poverty. That is why we have increased child tax credits, pension credits and the pension tax allowance in our Budgets. That is why the Chancellor said today in his letter to the Treasury Committee, repeating what he had said yesterday, that for the group that had missed out—those of pensionable age, between 60 and 64, who were benefiting from the 10p rate—we would present proposals, perhaps using the mechanism of the winter allowance, to provide them with additional payments that could be backdated to April this year. And that is why we will present proposals on the working tax credit, which involves issues relating to young people and part-time workers, in time for the pre-Budget report.
	We are determined to take action, because we are the party of fairness tackling poverty. I should prefer to be on this side of the House cutting poverty than to have been in the Conservative Government when they were in power trebling poverty.

David Cameron: I think that we should call this session Prime Minister's U-turns rather than Prime Minister's questions.
	I join the Prime Minister in paying tribute to Senior Aircraftman Graham Livingstone and Senior Aircraftman Gary Thompson, who were killed in Afghanistan on Sunday 13 April, and to Trooper Robert Pearson, who was killed on Monday. The whole country owes them a great debt of gratitude.
	I also associate my party with the Prime Minister's warm words about Gwyneth Dunwoody. She was the very model of an independent Back Bencher and Select Committee Chairman. She spoke her mind, she had no truck with political correctness, she was courageous in her political beliefs and she— [ Interruption. ] I can remember exactly where she sat. She was never afraid to hold any Government to account if she thought that they were doing the wrong thing. She will be sorely missed on both sides of the House.
	The Prime Minister's emergency announcement about income tax this morning represents a massive loss of authority. This morning, we have had panicked concessions before he came to the House of Commons. We were told that there would be no back-down; we have had a back-down. We were told that he could not rewrite the Budget; he is rewriting the Budget. We were told that there would be no concessions; there are now massive concessions. So will the Prime Minister tell us whether he is making those changes because he thought he would lose the vote next week?

Gordon Brown: We have said for some time that we want to do more to help people on low incomes. His party policy, two years ago, was to abolish the 10p rate. Last year, it was to abstain on the 10p rate. This year it is to keep the 10p rate. They are the "no, don't know, yes" party: they cannot make up their minds what they want to do. We will be consistent in our desire to tackle child poverty.

David Cameron: Consistent? Does the Prime Minister have any idea what a pathetic figure he cuts today? He is making these changes because he thought he would lose the vote. Or is this like the general election that he cancelled even though he thought he was going to win it? Is he not just taking people for fools once again? Why will he not admit it? He is not making these changes because he thinks they are right. He is not making these changes because he wants to help the people whom he hurt. He is making these changes because he was frightened of losing a vote. Why not admit it? Why not be straight with people?

Gordon Brown: I see the right hon. Gentleman's new-found enthusiasm for poverty has lasted only a few seconds. Why does he not address the central issue? The central issue is that we are taking more people out of poverty than any previous Government. If we took the advice of the Opposition, we would not have a minimum wage, but 2 million people are better off. If we took his advice, we would not have tax credits, but 6 million people are better off. If we took his advice, there would be £10 billion of tax cuts, depriving the poor of the public services they need. The choice is clear—between a Conservative party that would cut the incomes of the poor and a Labour party that will increase them.

David Cameron: What this is about is weakness, dithering and indecision from the Prime Minister. He talks about the central issue, so let us deal with the central issue. Why did all this begin? This began because as Chancellor of the Exchequer he stood there and presented a tax con Budget to try to wrong-foot the Opposition, to try to pose as a tax-cutter and to try to win a few cheap headlines in the newspapers. He did all that on the back of 5.3 million of the poorest people in our country. Will he admit now that that Budget was a gross miscalculation and it was immoral, and will he apologise for the tax con Budget?

Gordon Brown: Everybody now agrees that the 10p rate is not the best way to tackle poverty. The Conservative party agreed with that two years ago. They abstained on the vote a year ago and now they are supporting the 10p rate, and nobody believes their credibility on that matter.
	The Leader of the Opposition has said that he wished we had
	"simplified all our tax rates and produced one band, somewhere around 20 per cent., that applied to spending, saving, capital gains and income"
	and abolished
	"all...endless relief and credits".
	The policy he announced in 2002 was not just cutting the 10p rate but abolishing tax credits and allowances. That is not a party that cares about the poor; that is a party that put more people in poverty.

David Cameron: As ever, the Prime Minister was about to thump 5.3 million of the poorest people in our country and he is scrabbling around with policy documents trying to find some excuses. As ever, there is no apology or admission of guilt, just a U-turn to try to save his skin. Does that climbdown not tell us all we need to know about this Government? It is always about politics, not policy. It is always about calculation, not conviction. It is always about his self-interest, not the national interest. Does the Prime Minister think that his reputation can ever recover?

Gordon Brown: Why does the right hon. Gentleman not address the central issue, which is how we lift people out of low incomes and poverty in this country? Why does he not admit that as a result of our tax credits, which he opposed, 3 million children are in families with incomes of £80 more a week than in 1997? Why does he not admit that 2 million pensioners have incomes of £40 more than in 1997 because of the pension credit? None of that could have been achieved through the 10p rate. It can be achieved only through tax credits, which he opposes.
	Why does the right hon. Gentleman not recognise that under the Government 1 million pensioners and nearly 1 million children have been taken out of poverty and 3 million more jobs have been created? We are nearer to full employment than at any time in our history. None of that could have happened if we had followed the policies of the Conservative party.

David Cameron: The truth is that under this Government —[Hon. Members: "More!"] I shall tell you what is more: under this Government, 600,000 more people are in extreme poverty than when the Government came to power. The Prime Minister talks about the central issue. The central issue is his massive loss of authority. Was there ever anything more humiliating than a Prime Minister breaking off talks with the President and asking for an outside line in the White House in order to beg one of his Parliamentary Private Secretaries not to resign? This is what Labour MPs— [ Interruption. ] They should be quiet and listen. This is what Labour MPs are saying— [ Interruption. ]

Mr. Speaker: Order. Let the Leader of the Opposition speak— [ Interruption. ] The hon. Member for South Swindon (Anne Snelgrove) is far too noisy. So is the Lord High Chancellor—that is his title now.

David Cameron: It is not often that you have to give the Lord Chancellor an ASBO, Mr. Speaker.
	This is what Labour MPs are saying about their Prime Minister: he is losing touch; he does not know what fairness is; he needs to see the world through the eyes of voters; he is like a scared rabbit in the headlights. The Labour peer, Lord Desai, said that the Prime Minister's leadership style is like porridge. Another week like this and it will be Cheerios. Is it not the case that the Labour party has finally worked out that it has a loser, not a leader?

Gordon Brown: Why does the right hon. Gentleman never address the central issue— [ Interruption. ]

Mr. Speaker: Order. Allow the Prime Minister to be heard.

Gordon Brown: Why does the right hon. Gentleman never address the central issue? Child benefit increased from £11 to £20 under this Government. The poorest child in this country received £27 under the Conservatives and receives £75 under Labour. Tackling poverty so that we get nearly 1 million children and 1 million pensioners out of poverty—that is what we are doing. Here is the choice: a Labour Government who support a minimum wage and tackling child and pensioner poverty and who have got 3 million people in to jobs, or a Conservative party that would go for £10 billion of tax cuts, with the priority being stamp duty on shares and not the poorest in the country. I know which side the country is on.

David Cameron: The central issue is the Prime Minister's weakness and his inability to hold to a position for longer than half an hour. That is what today's humiliating climbdown is all about. Is not the real lesson today the fact that the only time that the Prime Minister listens to people is when he is faced with personal defeat? Is that not the lesson that everyone in this country, in London and beyond, should think about on 1 May, if they want to send a message to this weak and incompetent Government that enough is enough?

Gordon Brown: The Opposition used to oppose the 10p rate. Last year, they abstained on the 10p rate. This year, as a result of their opportunism, they wanted to keep it. We are for opportunity for everyone; they are for opportunism in everything.

Dawn Butler: OAPs can now travel with their freedom passes before 9 am. That has been warmly welcomed in my constituency in Brent and all around London, and has even been replicated around the UK. Does my right hon. Friend agree that the Opposition's proposal to abolish the freedom pass is more dim-witted than Dick Whittington?

Gordon Brown: I am proud of our record on free travel for pensioners. I am also proud of the fact that in London the Mayor has been able to extend free travel to many additional groups of people. However, we have to remember that the Conservative candidate for Mayor has said:
	"We have got to be absolutely clear where the scope for real economies is...the real big ticket...is the Metropolitan Police and Transport for London. That's where the real savings, believe me, are to be found."
	So the choice is very clear: investment in transport under Labour, cuts in transport under the Conservatives.

Nicholas Clegg: I should like to add my own expressions of sympathy and condolence to the family and friends of— [ Interruption. ]

Mr. Speaker: Order. The House must allow the right hon. Gentleman to be heard.

Nicholas Clegg: I should like to extend sympathy and condolence to the family and friends of Senior Aircraftman Graham Livingstone, Senior Aircraftman Gary Thompson and Trooper Robert Pearson. I also want to express my sympathy and condolence to the family and friends of that exceptional parliamentarian, the unforgettable and formidable Gwyneth Dunwoody. As we know, she enjoyed enormous admiration on all sides of the House.
	I thought that penalising the poor to reward the rich was the job of the Conservative party. The Prime Minister is deliberately making more than 5 million of the lowest earners in this country even worse off, so will he explain why he is doing the Tories' job for them?

Gordon Brown: We have done more to take children and pensioners out of poverty than any Government in the history of this country since the second world war. Contrary to the advice of the Liberal party, which wanted us to abolish the new deal, we have helped more young people and long-term unemployed into work than any Government since 1945. If we had taken the Liberal party's advice, there would have been high unemployment where there is now low unemployment.

Nicholas Clegg: Labour Members are now in full cry, but where were they on Budget day? Why were they silent then? The truth is that, under the Prime Minister's Government, income inequality is rising, working age poverty is up and now he is doubling the tax rate for the lowest earners. The Prime Minister used to be a man of principle but, if he cannot deliver on poverty, what on earth is the point of this increasingly pointless Prime Minister?

Gordon Brown: The point is to have economic growth in this country that gets more people into work. That could not happen under Liberal policies. The point of this Government is to take more people, including children and pensioners, out of poverty, and that is exactly what we are doing. I repeat: if we had followed the Liberal party's policies, there would be fewer people in work, and more in poverty.

Mike Gapes: Last week, the Prime Minister made a very successful visit to my constituency of Ilford. Does he agree that London is the most successful and diverse city in the world, with fantastic community relations? Investment has been made in its buses and trains, and there is still Crossrail to come. Does he think that all of that would be put at risk if someone with uncosted commitments and shadowy advisers were to be parachuted into our capital city?

Gordon Brown: People know that more people are able to use public transport—buses and the London underground—as a result of the Mayor of London's policies. In addition, more people are able to get affordable housing as a result of his policies. What would be completely unacceptable to the people of London would be to wake up and find that, as a result of a Conservative Mayor, housing was being cut, affordable housing was being taken away and the very transport services they relied on were being savagely cut. We will not allow that to happen.

James Duddridge: Tomorrow, teachers are going to be on strike and away from work. Today, should they be away from work on a bank holiday?

Gordon Brown: Let me deal with the first part of the question first. I think that it is very regrettable that teachers are going on strike tomorrow, and the reason is that even the chairman of the pay review body has said that this is an independent award, independently adjudicated, and one that the teachers should be prepared to accept. I hope that, after reflection, the teachers will reconsider the action that they are going to take in future on this matter.
	As far as St. George's day is concerned, it is a matter for public debate on whether this is going to be a holiday.

David Anderson: One of the best performing schools in this country is the Whickham sports college in my constituency. Sadly, a number of weeks ago it was badly damaged by fire. May I ask the Prime Minister to urge the Schools Minister to sit down with the local education authority and the school to try to bring forward Building Schools for the Future money to repair the school, and not let the Opposition do away with billions of pounds of the BSF programme?

Gordon Brown: I know that the school in my hon. Friend's constituency to which he refers was subject to a fire but that the children are now back in the school, and I know that he wants resources for urgent repair work. The Building Schools for the Future programme is increasing the number of secondary schools that are either renewed or completely rebuilt, and he is absolutely right—what would put that at risk is the Conservative proposal to take £4.5 billion from that programme and to deprive people of the secondary schools that they have been promised.

Robert Goodwill: The first stage of the renewable transport fuel scheme came into operation last week. May I ask the Prime Minister what his priority is? Is it to put bioethanol in a Range Rover's fuel tank or to put bread in an African's stomach?

Gordon Brown: We had a seminar on food yesterday in Downing street, with all the different organisations that are involved, and I think there is a general recognition that the policy on bioethanol has got to be reviewed. I may say that we have reviewed the tax incentives associated with it. But there is also a determination that we do more to increase the supply of food in the world. I think the hon. Gentleman will be aware that the increasing numbers of consumers in China and India are pushing up the demand for food, at the same time as the supply is not rising. That is why we discussed yesterday emergency measures that could both increase food supply in the short term and avoid famine, and increase food supply in the longer term to cut the prices of food in this country, as in every country in the world. I hope that there would be all-party agreement on the need to take action on this.

Kevin Barron: The Prime Minister will know that the Chancellor's recently implemented Budget has benefited four out of five households in this country. May I say to him that I am pleased that we are going to look at the fifth household as well? He will know that constituencies such as mine have suffered from poverty for generations now, not helped by Governments in the past who have closed coal mines and caused massive unemployment, and that this Government have no lessons to learn from the anti-poverty lobby sat on the Opposition Benches.

Gordon Brown: We have halved unemployment in the past 10 years. There are 3 million more people in jobs, and we have virtually eliminated long-term youth unemployment. We could not have done that without the new deal, which was opposed by the Opposition parties. We will continue to create jobs; the Opposition are the party that, in government, created mass unemployment.

James Gray: The Prime Minister claims that his is the party that looks after jobs. Will he explain why this week the chicken factory in Sutton Benger in my constituency was closed with the loss of 450 jobs, hard on the heels of Hygrade in Chippenham with 600 jobs, hard on the heels of St. Ivel in Wootton Basset with 500 jobs and hard on the heels of Dyson moving 1,000 jobs offshore? Does the Prime Minister take any personal responsibility at all for the meltdown in manufacturing in my constituency, or is it all somebody else's fault?

Gordon Brown: Of course whenever jobs go in any particular part of the country, that is to be regretted, but the important thing is that we are creating more new jobs, and creating them more quickly, than other countries. I just have to remind the hon. Gentleman that employment, according to the last figures, was at record levels—29.5 million people in work, 3 million more than in 1997—and that employment is up in every region and country of the United Kingdom. Our unemployment rate contrasts with a rate twice that in Germany and France and rising in America, and I think he should give some recognition to the fact that, even in difficult global times, we are continuing to create jobs and continuing to bring unemployment down.

John McFall: May I welcome the Chancellor's letter to me this morning on the Treasury inquiry and the 10p tax rate, and in particular his clear commitment to help the low-paid without children and the pensioners under 65 and to make those changes backdated to this financial year? The Prime Minister will be aware that the Treasury Committee has identified four groups, and that our inquiry will report before the Report stage of the Finance Bill. May I seek the Prime Minister's co-operation in seriously considering our recommendations and in contemplating any further measures that the Treasury Committee proposes in its inquiry?

Gordon Brown: I have to point out to the Treasury Committee that 70 per cent. of the people who were losing under the Budget have incomes above £20,000. Although many people who are low-paid and on low incomes are now being helped by the child tax credit, which we have raised, by pensioner tax allowances, which have been extended, by the pension credit, which is rising, and by the working tax credit, more can be done in the two areas I have talked about: helping pensioners aged 60 to 64—we shall bring forward proposals soon—and equally helping those on low pay who are part of the low-paid group in our society but not part of the working tax credit. That is what we will look at over the next period of time and we shall obviously do so in consultation with the Treasury Committee, but it is important to recognise that of those who lost in that Budget 70 per cent. earned above £20,000.

Dari Taylor: Does my right hon. Friend agree that the Army cadet forces, which are national voluntary youth organisations, are excellent and the best youth organisations in Great Britain today? They are organised by enthusiastic staff and officers. My detachment, the Durham ACF, takes 700 youngsters away during the summer holidays, many of whom would never go away on holiday. Will my right hon. Friend announce to the House today what my Government are to do to support further the future of the Army cadet forces?

Gordon Brown: I am grateful to my hon. Friend because she works with her local Army cadets and plays a prominent role with the cadet force in her area. I have been hugely impressed by the good work of our cadet forces—the combined cadet force, the sea cadet corps, the Army cadet force and the air training corps. They develop a sense of self-reliance and service to the community among young people and I praise all the adults involved. We will provide extra money to help the development of cadet forces, not just in some schools but across a whole range of schools. We are of course committed to providing more money for positive opportunities for young people in this country. The cadet forces play an important role and we are determined to extend them.

Lee Scott: My constituents in Ilford, North arrive home late at night to find some stations unmanned. Does the Prime Minister agree that the current moribund Mayor of London is letting them down and that next week, hopefully, we shall have a Mayor of London who will protect their safety?

Gordon Brown: If that is the case, the last thing the hon. Gentleman's party would want to do is to cut spending on transport, but that is exactly the policy of that party.

Lyn Brown: People on good salaries tend to ensure that they pay the correct amount of tax and take advantage of any tax concessions or tax relief available to them. People on low incomes do not. Will my right hon. Friend ensure that there is a concerted and sustained effort to ensure that people take full advantage of the tax credits, concessions and benefits to which they are entitled?

Gordon Brown: As my hon. Friend says, tax credits are important because they can take people out of poverty. That is why, whether it be tax credits or council tax benefit and housing benefit, we are promoting an awareness campaign targeted at pensioners so that they know of their rights and can apply for the benefits. We are determined that all the benefit due to pensioners and others gets to them as quickly as possible.

Tim Farron: The Westmorland general hospital is the major provider—or rather the provider—of acute coronary and other medical services to an area larger than Greater London, but those services are proposed for closure later this year. If we believe our local ambulance service—as of course we must—that would leave 63 per cent. of my constituents taking more than the golden hour to get to hospital in the event of a stroke or a heart attack. Will the Prime Minister take a personal interest in the matter and agree to meet me and local health professionals in South Lakeland to help to resolve it?

Gordon Brown: Obviously I shall look at what the hon. Gentleman says and the facts he brings before me, but he needs to put the matter in its proper perspective. We have doubled expenditure on the national health service, there are 30,000 more doctors and 80,000 more nurses, and 110 hospitals have either been built anew or are being refurbished. Of course I will look at what the hon. Gentleman says, but he should put it in its proper perspective: there is more investment than ever before in the health service in his area.

Nigel Griffiths: Will my right hon. Friend send a clear message to Robert Mugabe to stop brutalising legitimate opposition, to listen to the democratic will of Zimbabwe, and to go?

Gordon Brown: I agree with my hon. Friend that a message should be sent from the whole of the United Kingdom that what is happening in Zimbabwe—failing to announce an election result and trying to rig an election result—is completely unacceptable. I call on the whole world to express its view that that is completely unacceptable to the whole international community. Because of what has happened in South Africa, where there is an arms shipment trying to get to Zimbabwe, we will promote proposals for an embargo on all arms to Zimbabwe. At the same time, we ask all African Union observers and international observers to make their views known about the unfairness of the election.

Nigel Waterson: If the Prime Minister will not say sorry for the 10p tax fiasco, will he at least apologise for voting down the restoration of the earnings link for the state pension last night, or is sorry the hardest word?

Gordon Brown: Perhaps I could remind the hon. Gentleman that it was a Conservative Government who abolished the earnings link for pensions. Perhaps I could also remind him that it is a Labour Government who are committed to restoring it. The reason for that is that we take seriously our responsibility to the dignity and security of everyone in retirement. We will restore the earnings link for pensions.

Point of Order

Stephen Pound: On a point of order, Mr. Speaker. On Monday, the House heard a savage attack on Mr. Mohamed al-Fayed, made under parliamentary privilege. Can you tell me whether any redress at all exists for people who are traduced, even under parliamentary privilege?

Mr. Speaker: Order. Privilege is absolute.  [Interruption.] Order. I am not going to pursue the matter; I have given a ruling. Will hon. Members who are leaving the Chamber do so quietly?

Opposition Day
	 — 
	[10th Allotted Day]

Family Doctor Services

Mr. Speaker: I inform the House that I have selected the amendment in the name of the Prime Minister in both of today's debates.

Andrew Lansley: I beg to move,
	That this House supports the family doctor service, and recognises that it is the first point of contact for the majority of patients; further recognises the invaluable role that GPs have in the NHS; regrets the undermining and undervaluing of GPs by the Government; is concerned about the lack of empirical and clinical evidence for the establishment of polyclinics in every primary care trust; opposes the central imposition of polyclinics against local health needs and requirements; is further concerned about the delay in publishing evidence on the cost-effectiveness of walk-in centres; believes that patients should be able to choose the most convenient GP practice, whether close to home or work; calls for GPs to be given real budgets, incentives to make savings, the freedom to re-invest for their patients and the ability to innovate in contracts with healthcare providers; supports rewarding GPs who choose to provide services in deprived areas or areas of expanding population; and further supports the incorporation of patient-reported outcome measures into the Quality and Outcomes framework and the development of structures and services in general practice that are designed by GPs and primary care providers in response to patients' needs and choice.
	The purpose of the motion is straightforward. Through the new contract with general practitioners, the Government had a major opportunity to revive general practice in this country, and to rebase the NHS in patient-centred care and primary care-led services. They failed to do that; by contrast, they have entered into a conflict with general practitioners that will undermine the service. The Government are taking an approach to the reconfiguration of primary care services that matches the dangers of the approach that they took to reconfiguration of secondary care. The progressive centralisation of services, the progressive undermining of access to care, the progressive undermining of the ability of clinicians across the NHS to determine what is best for their patients—those are the tragic consequences of the Government's failure to negotiate the GP contract successfully. Their mean-minded approach is not to negotiate in partnership with general practitioners, but to try to arrive at a solution that cuts costs and centralises services, while undermining the independence and clinical effectiveness of general practice.

Robert Key: Does my hon. Friend agree that perhaps the single most popular feature of the national health service is the trust that patients have in their family practitioner, but that the Government are absolutely determined to prove that they do not trust family doctors any more? We have to rebuild that trust.

Andrew Lansley: My hon. Friend is right. I have heard exactly that from GPs in his constituency, who fear that a polyclinic will be established in or near Salisbury, the effect of which will be to force the closure of other GP practices and undermine the relationship with patients.
	Let me remind the House what the evidence tells us about the benefits of a strong primary care system. In the context of examining why the American health care system did not deliver successfully for Americans, which is an interesting subject, given the nature of the current debate on health care in the United States, Barbara Starfield, who is the professor of health care management at Johns Hopkins university in America, concluded:
	"There is no single or simple answer, but a large part of the story—and a part that is commonly overlooked—is precisely the predominance of specialist care over primary care."
	She went on to say, and this is a good definition of primary care:
	"Primary care deals with most health problems for most people most of the time. Its priorities are to be accessible as health needs arise; to focus on individuals over the long term; to offer comprehensive care for all common problems; and to coordinate services when care from elsewhere is needed."
	She continued:
	"There is lots of evidence"—
	indeed, there is international evidence—
	"that a good relationship with a freely chosen primary-care doctor, preferably over several years, is associated with better care, more appropriate care, better health, and much lower health costs."
	In light of that evidence, which demonstrates how successful primary care can be, I find it utterly astonishing that today, when we tabled a motion whose purpose is to support general practice and the family doctor service and to stress the importance of the relationship between patients and their doctor and the importance of continuity of care, which is so lacking in other parts of the health care system, the Government's amendment fails to support the family doctor service and focuses on their current ideological fixation in favour of large polyclinics, and in the process undermines precisely the continuity of care and the relationship between doctor and patient that the evidence suggests is so integral to the successful delivery of services.

Stewart Jackson: Does my hon. Friend share my concern that the Government's proposals represent a national template to be imposed on primary care trusts, with no thought given to social inequalities and need at the local level, or to the need to open more GP surgeries in areas of deprivation in our constituencies, rather than the Government's one-size-fits-all approach?

Andrew Lansley: My hon. Friend raises an important point. In the course of the GP contract negotiations, the move towards a quality and outcomes framework had real potential, but as the National Audit Office report published earlier this year set out starkly, in order to try to secure agreement with general practitioners the Government took a large amount of that money out of the pot and put it into the minimum practice income guarantee. Over the intervening years, the system of remuneration for GPs has not impacted on list size and need as it should have done, which would have helped the most deprived areas; nor has it incentivised more doctors to come into those areas.
	The Government's and everyone else's purpose in starting to negotiate the new GP contract back in 2002 was to deal with problems of recruitment and retention. Recruitment in deprived areas was most difficult and it remains difficult. The Government's response should have been to deal with that problem, not to try to impose a solution everywhere else. By encouraging PCTs to offer new practices in under-doctored areas, the Government are saying now the same thing as they said in 2006 in the community White Paper, which we supported throughout. However, it is wholly wrong for them to seek to impose a polyclinic system in London and across the country, including in the most under-doctored areas, which would deprive many people of access to GP surgeries in their local neighbourhood.

David Tredinnick: Does my hon. Friend agree that there is a danger that if patients do not have a named doctor—an individual doctor to whom they can relate—they may not report illnesses as soon as they should, which will add to the burden of costs to the health service?

Andrew Lansley: My hon. Friend is right. In an article in the  British Medical Journal on 22 March 2008, Martin Roland, professor of health care at the university of Manchester and director of the National Primary Care Research and Development Centre, said:
	"The UK system of universal registration with a single general practice promotes equity, provides a 'medical home' for coordinating care, and is an effective mechanism for holding providers to account for the quality of care provided."
	That is where my hon. Friend is coming from. That relationship between patients and their doctor is instrumental in delivering effective care, but the Government are determined to undermine it.  [Interruption.] The Secretary of State says "Rubbish," but he should look at what his own PCT is proposing in Hull. In a document, which I have seen, the purpose of which it acknowledges is to reconfigure GP care in the area, it says that its objective is to have fewer GP sites—by which I think it means practices—and to put polyclinics down in Hull. Hull is an under-doctored area, as the Secretary of State knows perfectly well. Of course there is a case for additional practices, but the consequence of the polyclinic plan will be that some of the existing practices will be shut down, and that will not enable services to be delivered more effectively in the area.

Graham Stuart: My constituency is in a rural area outside Hull, and it is rural areas that are particularly concerned about the proposals. They suffered when the Government tinkered with dentistry and my constituency has seen a major loss of dentistry services. The idea that the Secretary of State and the Government will now be tinkering with GP services horrifies my constituents.

Andrew Lansley: I agree with my hon. Friend. The impact on rural areas is one of the most significant and worrying aspects of the way in which the Government are going about this. I have been to many places throughout the country. Not so long ago I was talking to GPs in Worcester and to the local medical committee in Cornwall. One can imagine the situation: there are practices throughout Cornwall and the Department of Health tells the local PCT that it must have a polyclinic, but there is no obvious place for it, so it is just popped down next to a GP practice somewhere and practices in many neighbouring areas close down as a consequence.
	There are different models of care in different parts of the country. Interestingly, the south-west has some of the largest practices in the country—for example, I went to Frome—for the simple reason that sometimes a network system between a large GP practice and satellites is one of the most effective ways of ensuring access to neighbouring villages. But scrapping all that and not having an organic system that is developed by GPs themselves, in favour of the polyclinic system where GPs do not have independent contractor status and can no longer design services for their area's needs, will undermine access in rural areas at precisely the moment that towns and villages throughout the country are losing their post offices, shops, pubs and public services. Their GP surgery is one of the critical elements that they now perceive is under threat.

Tony Baldry: They are also losing their dispensaries. Is my hon. Friend aware that 8.5 million patients are in GP practices that dispense drugs? Under the Government's White Paper on the future of pharmacy services it will be almost impossible for GPs to dispense drugs in the future. Why on earth remove patient choice in this way? This is yet another service that will be lost in villages in my constituency and colleagues' constituencies.

Andrew Lansley: Yes, I am interested in what my hon. Friend says because in one particular respect the effect of the pharmacy White Paper, which was published during the recess, may well be to undermine dispensing by dispensing doctors, and it may all be part of a common process by the Government. The polyclinics are expensive beasts; they cost about £800,000 each, so money has to be raised for them. I suspect that in many cases the Government intend to ensure that they have a large pharmacy, which will take the pharmacy profits, and the dispensing doctors in local surgeries will lose out and shut down as a consequence.

Rob Marris: I caution the hon. Gentleman to go a little further down the line of variation around the country. Wolverhampton is one of the most deprived cities in the country. We have the excellent Phoenix medical centre, which might be termed a polyclinic, which is expanding its hours because it is so popular, and many of the services that it offers have been taken from the acute hospital, not from GPs. Correspondingly, the Castlecroft medical centre, with which I am registered, is building a brand new GPs' surgery, and the Mayfields medical centre, which opened recently, has a pharmacy alongside. The configuration in different parts of the country is different, and in Wolverhampton we will have three new GP practices from the Government, which are welcome because we are under-doctored.

Andrew Lansley: The hon. Gentleman has not been listening carefully, and he cannot have read the speech by my right hon. Friend the Member for Witney (Mr. Cameron) to the King's Fund on Monday. My right hon. Friend made it clear that we do not oppose change in general practice, but it must be driven by GPs themselves. [Hon. Members: "Why?] It must be driven by GPs in response to the needs of patients—it would be useful if the Secretary of State were to read the Opposition motion. The Government amendment does not provide any evidence that the Secretary of State sees any role for GPs or clinicians in interpreting the needs of patients, so I do not know how he thinks that patients' needs will be met.
	For the PCT to contract with additional practices to provide additional services in under-doctored areas is fine—we have always said that, and there is no reason why it should not go ahead. There is no reason why services that can be delivered more effectively in the community should not be delivered in the community, and there is no reason why GPs should not be able to commission services from a hospital or a community provider transferring services into the community. Sometimes, the hospital itself can provide those services, which certainly can involve diagnostic and treatment services. There will even be places where GP practices conclude that their premises are so poor that they need to come together in larger practices and premises. None of that causes me any problem at all.
	As the hon. Member for Wolverhampton, South-West (Rob Marris) represents a constituency in Wolverhampton, perhaps he has not carefully examined the Darzi plan in London and what is being rolled out in every PCT across the country in a one-size-fits-all fashion: the creation of polyclinics. The Darzi plan in London makes it clear that a polyclinic is 25 GPs occupying 16,000 sq ft costing £800,000 a year with all the services in that place. Where are those polyclinics being put? Last week, I was in Bexley, where a polyclinic is being located on the site of Queen Mary's hospital, Sidcup. In Epsom, a polyclinic has been proposed for the site of St. Helier hospital. That is not taking care closer to home; that is centralising primary care, which will take it further away from the people whom it is meant to serve.

Sandra Gidley: The hon. Gentleman seems to regard GPs as being at the centre of the infrastructure. How can we ensure that the best interests of patients are represented? What assessment has he made of the fact that GPs are most likely to commission services from themselves in areas in which they have a specialist interest? Is there not a conflict of interest, and where is the scrutiny when we discuss the best use of taxpayers' money?

Andrew Lansley: Last October, we published our document, "The patient will see you now doctor", which the hon. Lady has probably read. In that document, we made it clear that there must be a mechanism by which, beyond the boundary of the primary medical services contract, GPs can commission services from connected providers or providers that they control only in circumstances in which there has been a tendering process controlled by the PCT, which would prevent them from handing business to themselves. That is one of the problems with GP fundholding that needed to be sorted out. The Government have not sorted it out because the same problem is occurring in places where there has been any progress on practice-based commissioning.
	The hon. Lady also raised the issue of a voice for patients. We have repeatedly made it clear in this House that we need a strong voice for patients. We need "health watch" locally and nationally to make that happen, but where general practitioners are concerned, we also need the exercise of patient choice. Again, it is interesting to quote Martin Roland from Manchester:
	"The NHS goal of providing patient choice in primary care is not realised in many parts of the country where patients have little real choice of practice. Increased patient choice requires more high quality practices, not the small number of large practices that some polyclinic models suggest. We know that patients in small practices rate their care more highly in terms of both access and continuity. Indeed, although small practices show more variation in quality, on average, they achieved slightly higher levels of clinical quality than larger practices in the quality and outcomes framework."
	So having more high-quality practices, which include many smaller practices, is the route down which to go. Our patient choice proposals are similar to some that the Government made in the community White Paper of 2006. They are about making sure that when patients move from one practice to another, proper capitation follows them and to ensure that practices with open lists cannot be declared full when there is no justification for that.
	Those proposals are precisely the mechanisms to make sure that general practice, although integral to service delivery and commissioning, is none the less increasingly accountable to patients. At the moment, the Government seem to be moving to a world in which the only customer to matter is the primary care trust. To whom is the primary care trust accountable? The experience of everybody—including, I suspect, most of my hon. Friends across the country—is that primary care trusts are accountable only to the Department of Health and Ministers, who are the only people they ever listen to. At the moment, patients get no look in at all.

James Gray: rose—

Andrew Lansley: My hon. Friend has had plenty of experience of that in Wiltshire.

James Gray: I am most grateful to my hon. Friend for giving way; he is being very generous. What he describes has particular resonance in Wiltshire, where the PCT seems to be giving GPs incentives to move towards a polyclinic system. For example, a polyclinic is being proposed for halfway between the town of Corsham and the nearby village of Box. That would be convenient for neither place, but the PCT appears to be giving GPs in both places financial incentives to move towards it, even if that is not in patients' best interests.

Andrew Lansley: That is interesting. I understand exactly what my hon. Friend has said. If there were a rationale behind the measure, the many GPs whom I have met in many places across the country would be supporting it. If it was going to provide better services for their patients, they would understand that. In some places, better services are being provided. Macclesfield is an example. My hon. Friend the Member for Macclesfield (Sir Nicholas Winterton) is not here, but if he were, he would ask us to consider what happened in his constituency. General practices there wanted to come together and create a single premises for the whole town. They have done that, and the services are there. What is happening now? The Government say that there must be a polyclinic in every primary care trust, so the GPs in Macclesfield are threatened by the fact that the PCT wants to create another polyclinic in the PCT area. That would undermine those GPs' situation. Frankly, that is not acceptable.
	The Government made a complete mess of the GP contract. To give a simple measure of that, they paid £1.76 billion more than they were planning to. The National Audit Office reported that the Government said that under the new contract they were expecting a productivity gain in primary care of 1.5 per cent. a year. In fact, there was a drop in productivity of 2.5 per cent. in each of the first two years. The Government got the precise opposite of what they were hoping for—and we know the whole story of what happened to out-of-hours services across the country.
	Interestingly, local primary care trusts that cared about open access and extended opening hours for patients—they now claim that they do—had opportunities in the contract to provide them. Local enhanced services could have commissioned Saturday morning surgeries or extended opening hours on weekdays. I find it utterly astonishing that back in February, in the midst of a conflict with the British Medical Association, I could ask the Secretary of State whether he knew whether primary care trusts had commissioned local enhanced services for extended opening hours and get the answer that he did not even know. Having not used the contract for the purpose for which it was intended, the Government now blame GPs for the costs and consequences of a contract that they negotiated and pressed GPs to accept.

Andrew George: rose—

Tom Levitt: rose—

Andrew Lansley: I talked about Cornwall, so I shall give way to the hon. Member for St. Ives (Andrew George).

Andrew George: The hon. Gentleman mentioned Cornwall, where there is concern that, as a result of the proposed package, we will end up with a private sector solution. That issue concerns me. I note the hon. Gentleman's analysis: that the Secretary of State appears to be contradicting himself and imposing a top-down, centrally controlled solution in many areas. The Opposition motion talks about innovating in contracts with health care providers. To what extent does the hon. Gentleman believe that those contracts should include, or predominantly be, private sector contracts?

Andrew Lansley: I am talking about contracts between GPs as commissioners and the whole range of health care providers. Overwhelmingly, the contracts will be with NHS providers, although they will include private sector providers. I see absolutely no reason why there should not be an "any willing provider" policy in respect of both community provision and secondary provision.
	The hon. Member for St. Ives makes an important point; in the midst of what he was asking was the question of what the consequence of the shift to large polyclinics will be. In the past couple of days, we have seen on the Department's website evidence of how it is guiding primary care trusts to go about not only developing polyclinics but reconfiguring the whole of general practitioner services. It is clear that it wants to do that on the basis of a small number of contracts with large providers. That is true not only for this first polyclinic, but pretty much across the board.
	For a long time, the Department has wanted to get rid of the independent contractor status of GPs and turn them into salaried employees; Ministers seem now to have embraced that absurdity. Presumably, the Department is thinking that it can save a third of the cost of a GP, because a salaried GP costs only two thirds of what a principal in general practice costs. That is a dangerous route, because if practitioners lose their independent contractor status, they will find it impossible to take the position of GP budget holders or practice-based commissioners.
	In November 2004, we had a debate on family doctor services in the Opposition's time. The Government's response then was to say, "Look how useful practice-based commissioning will be for the future." Now we have another debate, and what is the Government's response? It is, "Look how useful polyclinics will be in future." Practice-based commissioning has disappeared. It has stalled across the country; more than half of primary care trusts are not giving it management support and the information to support it is not available to general practices. The proposed measure is a weak substitute for fundholding in the sense that it does not give real budgets or real incentives to save and reinvest for patients and it does not give the opportunity to innovate in contracts with health care providers.
	The Government's approach is a shameful abdication of the Government's existing policy, which two years ago Tony Blair said was absolutely central to health care reforms. He said that there should be practice-based commissioning, but that has disappeared and is off the lexicon; instead, the Government are reverting to type and going towards a centralised, top-down, one-size-fits-all approach.

Tom Levitt: The hon. Gentleman may not have seen the briefing e-mailed in the past hour to Members by the NHS Confederation, the independent organisation representing NHS bodies. It cites the National Audit Office, which has said how successful the GP contract has been. It says that £500 million-worth of savings on the back of the contract have been fed back into new services and how for the first time the contract relates patient outcomes and curing diseases to funding. All those things are improvements brought about by the GP contract and have been cited by the NHS Confederation. They fly in the face of what the hon. Gentleman is saying.

Andrew Lansley: The NHS Confederation is "independent", is it? It is the body that negotiated the contract and is responsible, with the Department, for the outcome. It is hardly independent. The National Audit Office is independent, and its conclusions on the contract need to be read. The contract was principally about delivering GP services where they were weakest; let me quote paragraph 4.13 of the NAO report:
	"Elements of the new contract have not necessarily supported practices in deprived areas. The development of a new, needs-based funding formula was the key element of the new contract aimed at reducing inequality of provision. However, the introduction of the Minimum Practice Income Guarantee significantly reduced the redistributive impact of the formula".
	The contract has undermined the tackling of health inequalities, which were at the heart of what it was trying to deliver. I will not go on about some of the other things, but if the hon. Gentleman wants another independent view about polyclinics, I refer him to the Patients Association, which understandably sees things entirely from the patient's point of view. Dr. Halperin, its chairman, said:
	"What I believe patients want is to see their own GP, to have a regular relationship with a GP, and when they require further or more specialist treatment, to go to a hospital...what you"—
	that is, the Government—
	"are now doing is interposing a third layer of a polyclinic and I really don't see any advantage for it."

Andrew Murrison: The hon. Member for High Peak (Tom Levitt) cited the NAO and the NHS Confederation report, and he quoted selectively. Does my hon. Friend recall the NAO pointing out that the GP contract was overspent to the tune of £1.76 billion? Who does the NAO think might be to blame for that?

Andrew Lansley: We know exactly who is to blame for that—the Government. To be fair to NHS employers and the NHS Confederation, when it came down to it they were overawed by the Government, who put in their own interpretation of their estimate of the QOF—quality and outcomes framework—points that were going to be gathered by GPs. The British Medical Association, to be fair, said pretty clearly that it thought that it would be a higher figure. The difference on the QOF was about 16 per cent.—that is about 160 points, and there is £125 a point, so that is about £20,000 per GP. The Government have therefore ended up spending millions more than they ever intended. That was not simply because they got more out of the contract but because they did not put into their negotiations a proper understanding of the existing practice of GPs before they started to negotiate it.

Ann Winterton: Will my hon. Friend give way?

Andrew Lansley: No, if my hon. Friend will forgive me, because I need to make this clear.
	The purpose of this debate is not only to criticise polyclinics and how the Government are going about this but to make it clear that the House should express its support for the family doctor service and for the future of general practice, which needs to develop in future. We need to have GP commissioning; GPs must be responsible for real budgets. There is clearly an opportunity for GPs to manage care on behalf of their patients so that the relationships and continuity that they already have can be turned into something that delivers integrated care for patients and so that where services are provided they are in the best interests of patients. GPs should not be immune from competition. There should be a role for alternative providers and different models of care, but it should not be a one-size, top-down kind of care. We need patient choice of the kind that I described. Patients should be able to exercise not only choice in secondary care but choice in who is their primary care provider. We should ensure that the remuneration of GPs not only incentivises them to be in socially and economically deprived areas looking after the patients who are most in need of their primary care services but is geared towards quality and outcomes, including patient-reported outcomes, not just the process measures that are in the QOF at the moment.
	We know that primary care is highly effective—the international evidence shows that—and primary care in this country is in many respects the envy of many other countries. Primary care is instrumental to the delivery not only of high-quality care but of cost-controlled care. We can see, in this country and in others, what happens when the people making clinical decisions are not also responsible for the resource consequences. GPs can be those people. They will be well rewarded, as they are and should be, but they should have the responsibility that goes with it. They should not be treated, as the Government have treated them, as production line drones who behave only as the Government direct.
	We need a future for general practice that responds to the needs of patients and to GPs' own clinical evidence about what is in the best interests of the patients and the service. The Government use the excuse of patients wanting longer opening hours, although only 4 per cent. of patients expressed a desire for longer weekday openings. Most GPs to whom I have spoken would be happy to respond to that and would have no difficulty in doing so. Earlier this week, I spoke to a GP in Camden who said that when she went to the primary care trust and said that she wanted to open at 7 o'clock in the morning because all the patients who wanted extended hours wanted them at that time, she was told, "No, that is not good enough because the Government have told us that you've got to open until 8 o'clock in the evening." She does not have any patients who want to go there at 8 o'clock in the evening—they want to arrive at 7 o'clock in the morning—but the PCT is now in such a top-down system that it will not even listen to GPs and patients.

John Pugh: Will the hon. Gentleman give way?

Andrew Lansley: No, I am sorry—I am about to conclude.
	Using the excuse of the row with the BMA and the fact that GPs' salaries appear to have increased—although we do not have the last two years' data, when GP remuneration will have been at a static level—the Government are embarking on the destruction of the family doctor service as we know it. Access to primary care in local neighbourhoods will be lost, and rural areas will see a decline in further access to services. In many neighbourhoods in the most deprived areas, local pharmacies and local GP surgeries are among the public services that people most value and are some of the few things that really work at the moment, yet they too will disappear, as we can see from the example in the Secretary of State's own constituency. The relationships between patients and GPs will be lost, continuity of care will be lost, and the independence of GPs will be lost and, as a consequence, the ability of primary care-led commissioning directly responsive to patients' needs will also be lost.

Ann Winterton: rose—

Andrew Lansley: I cannot resist my hon. Friend.

Ann Winterton: There is one danger that my hon. Friend has omitted in talking about the push for polyclinics—the impact that they may have on the delivery of local services in, for example, cottage hospitals and smaller district general hospitals if the PCT commissions more services that can be delivered in polyclinics. As I am sure that my hon. Friend knows, my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton) supported the first getting together of GPs on condition that that arrangement did not in any way challenge the services provided by Macclesfield district general hospital, which is also valuable to my constituency.

Andrew Lansley: I am grateful to my hon. Friend. She may have heard me refer to the GPs coming together in Macclesfield, which demonstrates what is possible if they are given the opportunity to commission services. We are not saying that there should not be change, but that it must be driven by the needs of an area. That is why we make it absolutely clear in our motion that we are opposed to a one-size-fits-all, top-down system that is not responsive to local health needs and circumstances. My hon. Friend and her very hon. Friend fight hard for the needs of their area, as can be seen in the way that they have fought not only for the GPs there but for Macclesfield district general hospital when it was threatened with reconfigurations.
	The Government's polyclinic plan will be the triumph of the one-size-fits-all approach and bureaucracy in place of clinical evidence and professionally-led—clinician-led—services. I am sorry that Government Front Benchers, in their amendment to our motion, cannot even bring themselves to support the family doctor service. They removed that from the motion where they could have left it in. In their amendment, they propagate the fallacy that the interests of GPs and patients are opposed, but they are not—GPs and patients have common interests, and patients trust GPs. There is an overwhelming sense of trust in GPs, while 97 per cent. of GPs have now reached the point where they have no confidence in the Government. That is, I am afraid, a message that the Government really should have listened to. They cannot even bring themselves to mention in their amendment the benefit of practice-based commissioning, which two years ago was a key health reform.
	I am afraid that ignorance and ideology make a fatal combination. The Secretary of State has picked up the ideology of centralisation and combined it with an ignorance of general practice. When I asked about two months ago how many GP practices the Secretary of State had visited, the Minister of State, the hon. Member for Exeter (Mr. Bradshaw), told me that the Secretary of State had visited one GP practice— [ Interruption. ] I am told that it is now two.

Rob Marris: Is he better now?

Andrew Lansley: Not in a personal capacity—in a professional capacity.
	It is entirely typical of this Government that a new Secretary of State comes in, knows absolutely nothing about health, would prefer to be doing something different, visits one GP practice in Kingston that happens to extend its opening hours to 8 pm because it is in an area that has a lot of commuters, and draws the conclusion that every GP practice all over the country should do exactly the same thing. It is ignorance and ideology in the most absurd combination.
	The Labour Government appear no longer able to understand primary care. They do not appear to value it but are none the less determined to interfere with it in the most high-handed and ideological fashion. Our motion sets out a framework for general practice. It sets out a framework of values that we are now going to encourage GPs and patients across the country to sign up to—a framework where the value of general practice is not only understood but enhanced through developing GP budget-holding and patient choice. That would be in the real interests of patients and of the NHS. I commend the motion to the House.

Alan Johnson: I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
	"welcomes the fact that the Government is providing £250 million, in addition to existing GP services, for 152 new state-of-the-art GP-led health centres open from 8 a.m. to 8 p.m., seven days a week; notes that these will offer a wide range of health services including prebookable GP appointments and walk-in services; further notes that where patients previously had trouble seeing their GP or had to make numerous visits to a variety of health professionals, they will now be able to see a doctor more quickly, collect their prescriptions, get their eyes tested, have a variety of diagnostic tests or see a physiotherapist in the same building and at times convenient to the patient; further welcomes the additional centrally funded 100 GP practices to be located in the most deprived areas which will have a strong focus on promoting health and reducing inequalities; acknowledges the landmark agreement with GPs to extend surgery hours in evenings and on Saturdays and agrees that extended access will benefit hardworking families; further welcomes the extension of the role of pharmacies to be able to prescribe for and deal with minor ailments on the NHS, as well as promoting good health, supporting those with long-term conditions and preventing illnesses through additional screening and advice; recognises that the Government is on the side of patients; and agrees that extending access to GP services through extended hours and new GP health centres can have a real impact on health inequalities."
	I am delighted that the Conservatives have used this Opposition day debate to allow us to highlight the investment that we are making in primary care and the measures that we are taking to give the public better access to the improved services that they require. Also, it is very good of the Conservatives to commemorate the 60th anniversary of the NHS by seeking to recreate the historical position of the Conservative party in 1948—opposed to better services for patients, defending instead the narrow vested interests of the more reactionary elements of the profession. I guess we could call it a sort of parliamentary version of the television programme, "Casualty 1907".
	Making sure that every citizen has access, free of charge, to a local GP if they are sick or worried about their health was the major premise on which the NHS was established, by a Labour Government in the face of fierce opposition from the Conservative party and its allies in the profession 60 years ago—it is really good to commemorate that in this anniversary year. We continue to support that premise. The role of the general practitioner as provider and commissioner of care, and as a strong advocate for their patients' health and well-being, is central to everything that we are doing. It is why we have made an unparalleled investment in GP services, from £3 billion in 1997 to £8 billion today. It is why there are now 5,318 more GPs and 4,471 more practice nurses than there were in 1997. It is why GPs now spend, on average, 50 per cent. more time with each patient than they did in the 1990s. And it is why we have increased the pay and reduced the hours of GPs, thus resolving a serious recruitment problem, while introducing a quality and outcomes framework regarded with admiration around the world, which helps to make GPs central to the care of people with long-term conditions, achieving documented improvements in health outcomes for conditions such as asthma and diabetes. The Tory motion describes all of that as "undermining and undervaluing...GPs". I can think of lots of professions that would love to be undermined and undervalued in such a way.

Nadine Dorries: Given what the Secretary of State has just said, does he agree that GPs represent one of the most cost-effective and efficient aspects of health care in the UK?

Alan Johnson: I believe that absolutely. GPs are fundamentally important to everything that happens in the NHS, and we have world-class primary care. That is why we have introduced those measures over the past 10 years—to bring in more investment and to attract more GPs, while ensuring that they are better rewarded and can spend more time with their patients.
	Let me deal with the rather pathetic attempt by the hon. Member for South Cambridgeshire (Mr. Lansley) to misrepresent our position. There is no national policy for replacing traditional GP surgeries with health centres or, indeed, polyclinics. There are no plans to herd GPs against their will, or the will of patients, into super-surgeries. We are not seeking to reduce the number of GP practices. I quote from the interim report of my noble Friend Lord Darzi—this also answers the intervention made by the hon. Member for Mid-Bedfordshire (Mrs. Dorries)— who said:
	"More than 80 per cent of NHS patient care takes place in primary care... Our registered GP list system is renowned internationally. Our primary care system co-ordinates care for patients in a way few other countries match. There are strong bonds between staff and their patients, families and carers."

Stewart Jackson: One always knows that the Labour party's arguments on health are vacuous when it is shroud-waving about the events of 60 years ago. In the week when the Government's own Back Benchers are revolting—even more than normal—over the abolition of the 10p tax band, is it not ironic that these proposals will potentially have the most significant impact on the oldest, the poorest, the sickest and those with the least voice in Government and policy making? That is from a Labour Government of 11 years' standing.

Alan Johnson: The hon. Gentleman will have to do better or I will not allow him to intervene again.
	What are we doing? What is the destructive policy against which the Conservative party has decided to take up arms? Of what crime against humanity are we guilty? What devastating blow are we dealing to communities throughout the country? We plead guilty to investing an additional £250 million to enable the local NHS to develop more than 150 GP-led health centres in every part of the country, open seven days a week from 8 am to 8 pm, and more than 100 new GP practices in some of the most deprived areas of the country—deprived not just in terms of poverty but in terms of people's inability to access primary care because they live in so-called under-doctored areas. A clear correlation is seen in the areas with the lowest life expectancy and the fewest GPs per head of population.
	What is the Conservative party's policy for dealing with under-doctored areas? We see it in the rather vacuous petition—"anodyne", as one GP described it—that they have launched. It says that GPs should be free to determine where they practise. That is the situation now and, by and large, they do not choose to practise in deprived areas in sufficient numbers. If they are to do so, under the Conservatives' primary care policy, it must be for more pay. In the words of the petition, they must be
	"rewarded for working in socio-economically deprived areas."
	The Opposition motion asks right hon. and hon. Members to support
	"rewarding GPs who choose to provide services in deprived areas",
	but the inequalities of access have existed for 60 years. By and large, GPs have chosen not to locate in such areas, which is why we have taken the decisive step of investing new money in new health centres to provide extra services—not to replace existing services. Those health centres will have a strong focus on the promotion of health and the prevention of health inequalities. Most will provide physiotherapy, pharmacies, district nursing and minor surgery services.

Andrew George: A moment ago, the Secretary of State said that he pleaded guilty to making a major investment in primary care, and without question the extra money is welcome. However, he is not pleading guilty to contradicting his welcome words of 4 July last year, when he said that he would give the NHS a
	"sustained period of organisational and financial stability"
	and that
	"there will be no further centrally dictated, top-down restructuring".— [ Official Report, 4 July 2007; Vol. 462, c. 962.]
	If he wants to realise those aims, why does he not allow local communities to decide how best to achieve the objectives, which he rightly identifies, that will meet the needs of deprived communities, instead of having this centrally dictated, top-down restructuring, which could produce the same sort of ridiculous results as the independent treatment centres that have wasted millions of pounds in Cornwall?

Alan Johnson: I announced last July that there would be no more structural reorganisation in the NHS—no more changes to strategic health authorities and no more merging of PCTs—and we have kept to that. As I hope the hon. Gentleman will accept when I come to the gist of my speech, we are not imposing a top-down measure. We are providing £250 million for investment in the expansion of the primary care service, mostly to take services away from hospitals and bring them into local communities. That is the major reason for the investment.

Brian Iddon: Does my right hon. Friend agree that in areas such as mine, which is a heavily and densely populated one, with narrow streets and little car parking, many GPs have welcomed the chance to move into modern premises with car parking for ambulances and patients' cars, and the ability to expand their services and share support staff?

Alan Johnson: Indeed, and that is the experience throughout the country. It is the experience of my constituency, which the constituency of the hon. Member for South Cambridgeshire is a long way away from. In Hull, there has been a revolution in primary care services, which is happening in cities and communities throughout the country.

Tom Levitt: Further to my right hon. Friend's point, I am grateful for the assurances that he has given about structural change and GP practices. Has it not been the case over the years that GPs have, by and large, migrated from single-handed practices into common practices precisely because they can deliver more and better services on the spot? Will he ensure that there is no ban on single-handed practices, while acknowledging that the pattern may well be for such practices to refer patients on to multiple-handed practices so that people can receive their care locally?

Alan Johnson: My hon. Friend makes an important point. We can take the example of London, where polyclinics are a specific proposition. A review of health services in London, carried out by NHS London and involving London clinicians, pointed out that for 40 years people have been trying to revamp, reorganise and update services there. In London, 54 per cent. of GP practices are single-handed, compared with an average of 40 per cent. throughout the country, and 97 per cent. of patients have to go to hospital for out-patient appointments. That figure stands at 90 per cent. in the rest of the country, which is still too high. The vast majority of people want to access such services in the community. In London, we have the worst problem of people going to A and E and clogging it up when they should go to primary care. That is why Lord Ara Darzi, working with clinicians in London, has devised a specific model for London, which is not a blueprint for the rest of the country.

Mark Simmonds: The Secretary of State said that the policy was not centralised or imposed. If a primary care trust told the Department that it did not want to provide a polyclinic, but preferred to use the resources in another way, would he allow it to do that?

Alan Johnson: There would be no problem with that, given that we are not specifying polyclinics as any part of the exercise. The crucial point is that the local NHS will develop services in ways that best meet the needs of the local population by engaging members of the public and local doctors, nurses and other health care professionals. That is the way to implement the proposal.

Norman Lamb: The Secretary of State referred to the extra investment in new practices in under-doctored areas, and I fully support that. Does he agree that it would be ludicrous if the operation of the GP contract results in financial incentives being greater for practices in the leafy suburbs than for those in disadvantaged areas? Practices in disadvantaged areas receive less pay on average than those in wealthier areas.

Alan Johnson: That is an important point for our health inequalities strategy, which we will publish soon. As Lord Ara Darzi pointed out in his interim report, it is also a major issue for his continuing work.

Rob Marris: I welcome my right hon. Friend's remarks. May I urge him not to give in to the calls for a free-for-all for GPs? It has not worked in cities such as Wolverhampton. As a bit of an old Labourite—I know that he is, too—I want a bit of planning. I want a bit of planning from the excellent Wolverhampton primary care trust, engaging with local people. However, I also want some accountability on the part of the PCT, because it is not as accountable as it should be. Even though it does an excellent job, we need more accountability by primary care trusts.

Alan Johnson: I am tempted to say that, if a bedpan falls on the floor in a Wolverhampton hospital, I expect it to echo around Whitehall, to paraphrase Nye Bevan's famous centralising edict. My hon. Friend and the hon. Member for South Cambridgeshire make a fair point about PCT accountability. As part of the review and our attempts to construct a constitution for the NHS's 60th birthday, we need to introduce greater accountability, especially as we distribute to PCTs a far greater proportion of the central pot than we have ever done.

Tom Levitt: I am grateful for my right hon. Friend's reassurance about polyclinics. When I first heard the word, I thought that a polyclinic was for treating people who were as sick as a parrot; clearly, I was wrong. Will my right hon. Friend clarify exactly how, in principle, a polyclinic is different from, for example, the three GP practices in Buxton, where five, six or more GPs, practice nurses and other health professionals work in one area in a system that has evolved over the years to provide better health care for people locally?

Alan Johnson: Those definitions of a polyclinic and a health centre—

Andrew Lansley: It would be useful to know.

Alan Johnson: The hon. Gentleman says that it is useful to know. In the London context, we are considering including services that were previously perceived as secondary in primary care services, thus providing an integrated service, whereby patients can access a far wider range of services than they could traditionally. However, I must say that we have had such services in Hull for years and never called them polyclinics. The chief executive of the NHS said that he went to a place recently and was told that it did not want a polyclinic. He was speaking in a community hospital, which was, to all intents and purposes, a polyclinic. There is, therefore, a problem with definitions.

Andrew Murrison: The Secretary of State began to discuss public engagement, and engagement with stakeholders is important, but will he reassure us that there will be no more ridiculous, sham consultations on reorganising primary and intermediate health care? Such consultations happened in Wiltshire, where three of the four community hospitals closed, much against local people's wishes.

Alan Johnson: The Minister of State, Department of Health, my hon. Friend the Member for Exeter (Mr. Bradshaw), tells me that that horrendous action was supported by the Conservative-run overview and scrutiny committee. However, I accept the tenor of the hon. Gentleman's points. In the big reconfiguration in Greater Manchester, there was an absence of proper involvement and engagement by the public in the early stages. When the proper engagement took place, we reached an acceptable solution, which everyone supported locally.
	There has been a move towards group practices, but that has been driven by GPs as a way to improve services for their patients. In my constituency, single-handed practices are increasingly moving into fabulous new health centres, with an investment of £14.8 million in new facilities, rising to nearly £30 million by 2009 under the local improvement finance trust programme, which is transforming primary health care in our city. However, what works for Kingston upon Hull will not necessarily be right for Kingston upon Thames. It does not mean the end for single-handed practices, many of which provide an excellent service to patients across the country; they will continue where they are right for patients.

Charles Walker: As the Secretary of State knows, I campaigned in my constituency for an urgent care centre as part of the effort to ensure that hospital reconfiguration in the area did not leave my constituents short of services. My constituents want the reassurance of an urgent care centre, but they also want GP practices where there is a familiar, friendly face. Can the Secretary of State give an assurance that people will have a family doctor, who comes out on visits and is there for them?

Alan Johnson: Of course I can. Two central fallacies underpin the Tory party position. The first is that we are imposing a system of polyclinics throughout the country. We are not. The second is that, if an area has a group practice or a health centre, or if GPs decide to move into much better facilities where several practices operate together, people can no longer see their own GP. That is nonsense. It is wrong to suggest that the proposals signal the death of the important patient-GP relationship; they do not.
	Individual, single-handed GP practices will continue to operate where they are right for patients. When we talk about developing health centres, or what some local parts of the health service describe as polyclinics, we are not considering a single, fixed model of care. Those terms describe flexible models for bringing primary care together with a range of other services, be they diagnostic services, specialist care for patients with long-term conditions such as diabetes, or adult social care. It is hardly a novel idea. Health centres featured in the earliest descriptions of the national health service in 1948. Examples abound of GPs, nurses, specialists and other health care professionals coming together to provide integrated care for patients. With advances in new technology and medical science, we can and should do that to a greater extent in much more imaginative ways.
	We are also guilty as charged of expanding access both through the new health centres and the new arrangements that we are introducing for extending opening times at GP surgeries in the evenings and on Saturday mornings. The Conservative party appears to have adopted wholesale the distorted view expressed in some quarters of the BMA and articulated by the right hon. Member for Witney (Mr. Cameron), who believes that the cash-rich, time-poor professionals—I paraphrase from his speech on Monday—who need to get their back problem fixed, as well as some jabs for a business trip to India, will be the main beneficiaries. One has only to visit practices that are already open for longer in the evenings and weekends to find that it is not, as so often claimed, a service for the worried well. Those who are most likely to benefit from extended hours are manual workers worried about taking time off, parents balancing child care responsibilities, certain ethnic minorities who are most dissatisfied with current access arrangements, and those very pensioners and mothers with young children, who are said by opponents of extended hours to want only a Monday to Friday service, with a half day on Wednesday.

Andrew Lansley: I am grateful to the Secretary of State for giving way. When we had a debate on the issue three and a half years ago, the precise point made by the right hon. Member for Barrow and Furness (Mr. Hutton), then a Health Minister, was that the Government were planning a new system of what were called walk-in centres, which would give patients greater access and enable them to receive medical care in the evening and at weekends. What has happened to walk-in centres? The Minister here today promised to publish a review of walk-in centres last summer. It has not been published, but simply dropped in some distant part of the Department. Are walk-in centres not the mechanism that the Government said should be used?

Alan Johnson: Bristol university has already conducted an assessment of walk-in centres. It said that they were good on quality and accessibility, but that more work needed to be done on their finances. That work is ongoing and forms part of the Darzi review.

Neil Turner: May I tell the Secretary of State about a new health centre in Wigan called Boston house, which has been open for three or four years? Taking some of the services and moving them there has transformed the lives of many patients living in the area that I represent. We are talking about a health centre outside a general hospital that provides renal services. People in Wigan have always had to go to Bolton, Salford and other places nearby for renal dialysis. Now we have that in Wigan, located in primary rather than secondary care. Is that not what health centres are all about—transforming the lives of people by taking things out of secondary care and into primary care?

Alan Johnson: That is a perfect example of why we should thank the Conservative party for allowing us to have this Opposition day debate, when we can highlight the important improvements being made throughout the country. We offer better access and improved facilities. What do the Tories offer? They offer a petition for GPs pronouncing on their absolute right to put their own interests before those of the public.

Mark Simmonds: Nonsense.

Alan Johnson: So says one of the architects of that petition. It is clear what the petition is about. I have heard the arguments from various quarters. In that petition we hear the hallowed cry of those who ask why they should have to open on Saturday, when their accountant, working in a similar profession, is not open on a Saturday. As one GP down in the west country put it to me in wonderful terms the other week, "If the public are seriously worried about their health, they should be prepared to take time off during the week to come to my surgeries"—at times that suited him, obviously. What we have in the Opposition's petition is the articulation of all that. It says that GPs should be
	"rewarded for working in socio-economically deprived areas,"
	and continues:
	"We also believe we should be free to determine the opening hours, size and locations of our practices".
	That is a petition for GPs to sign telling us how important it is to look after their interests rather than those of the patients. That is the position that the Opposition have put them in.

Peter Bone: Does the Secretary of State accept that in some parts of the country GPs have already got together to provide perfectly satisfactory out-of-hours services that nobody wants changed?

Alan Johnson: The common problem among those on the Conservative Benches is that they do not understand the difference between extended hours and out-of-hours services, to which I shall come in a second.
	The Opposition offer a return to the bad old days, when GPs were effectively responsible for their patients 24 hours a day, 365 days a year. The Royal College of Physicians is among the many organisations that have pointed to the international evidence of the risk to patient safety that long hours pose. How could we ever have supported a system in which tired GPs called out in the middle of the night had to attend patients the next morning, and it was common to wait weeks instead of days for an appointment that would often be little more than cursory, because of the pressures that GPs faced?
	The new arrangements for extended hours will mean that the average-sized practice, run by three to four GPs, will open for an extra three hours a week. Those arrangements offer a fair deal for both doctor and patient, and I am pleased that the British Medical Association has given its agreement, following a ballot of its members in which 92 per cent. voted in favour.
	The Opposition claim that they support the traditional family practice, but what does this mean—restricted opening hours, problems getting appointments, tired GPs and under-doctored areas? Yes, small family practices can work well and are popular with many patients; but we should not support this fixed model of primary care any more than we should support any other fixed model, particularly at the expense of improving access to primary care in areas of most acute need. Patients should be able to see a GP or a practice nurse at a time and location that is convenient to them. That should be a defining feature of a world-class primary care system, but it will not be for politicians to determine nationally what will work best locally.
	The next stage review, led by the noble Lord Darzi of Denham, is a bottom-up process, with 2,000 clinicians engaged with the public, unions and patient groups in determining how clinical care can be improved in every part of the country. That will be another stage in the exciting journey that commenced with the NHS plan and that has seen greater investment, improved resources, new hospitals and better clinical outcomes—a journey to an NHS that is world class in all aspects, instead of world class in just some.

Rob Marris: Will my right hon. Friend give way?

Alan Johnson: No, I am coming to the end of my speech.
	Although the Conservative party professes to have joined us in supporting the NHS, it has proved by its approach to primary care that it remains stuck in the past—conservative in every respect and willing to put vested interests before better service to the public. I commend the amendment to the House.

Norman Lamb: This is an opportune time for us to discuss the Government's record and their plans for family doctors. The debate gives us Liberal Democrats an opportunity to reaffirm our opposition to central control of local health services.
	I was fascinated when the Secretary of State again tantalisingly indicated his recognition of the lack of accountability among primary care trusts to the communities that they serve, while the Conservatives rejected any change to the accountability of primary care trusts. May I commend to the Secretary of State the Liberal Democrats' proposals to democratise the commissioning of health care? Primary care trust boards should be elected, not appointed nationally. Ultimately, the Conservatives want to retain the central model of control of the NHS. The Secretary of State suggested that he recognised the case that we had made, but will he go the whole way and provide proper accountability to the communities that trusts serve? We wait to see what his announcement amounts to.
	I want to talk about the morale of general practice. It is important to recognise that the network of family doctors in this country is the bedrock of health care and the NHS. As others have said, that network is the envy of the world. We should not, however, be complacent or take the view that the service is never capable of improvement to meet modern needs. We should always be prepared to accept the case for evidence-based reform. The Government must recognise that they damage the service, which is so widely supported among the general public, at their peril, because it is such an important part of our health service.
	Whatever the Secretary of State says about how fortunate GPs are, given the way in which the Government have treated them, he must recognise that morale among GPs is very low. I am sure that he talks to GPs throughout the country, so I am sure that he recognises that they feel demoralised. Indeed, one Norfolk GP said to me recently, "We're well paid—we recognise that—but we feel that some of our professionalism has been taken away from us, because we're dictated to so much from up above"—that is, from Whitehall. When GPs try to develop practice-based commissioning, those who make the decisions often do not listen. When they try to refer patients for services such as those for teenagers with mental health problems and discover that services are inadequate or simply non-existent in rural Norfolk, they cannot feel much pride in their job, despite the fact that they are being well paid. The Secretary of State should recognise the real concerns among general practitioners, who take pride in their work, which they undertake for the very best of motives. Their concerns should not simply be dismissed as unfair attacks on the Government.
	I have spoken to a number of GPs in the past fortnight. They raised several issues with me, the first of which was the GP contract, and I shall come back to that in a moment. The second issue was the state of practice-based commissioning and where it is going. The Conservative spokesman rightly referred to the fact that it appeared to have completely stalled, certainly in many parts of the country. The third issue is the central imposition of what we must now call health centres, rather than polyclinics. I shall return to that issue later as well.
	Are those concerns justified? Doctors feel that they are taking the blame for a contract that was ultimately the Government's contract. It was forced through three years ago, and GP leaders at the time warned the Government of the effect it would have. The National Audit Office reports that there has been a £1.76 billion overspend on the contract since its introduction. Remarkably, the contract frustrates GPs while failing to be consistent with some of the Government's key objectives, particularly in regard to preventive care, despite the potential of the quality and outcomes framework—QOF— system. I fully recognise that the introduction of that system could do much to incentivise preventive care. The contract also fails to be consistent with the Government's stated objectives on reducing inequalities.

John Pugh: Is my hon. Friend aware that the NAO report states quite explicitly that there has been no productivity increase in GP practices?

Norman Lamb: My hon. Friend is absolutely right to highlight that. We should acknowledge, however, that measures of productivity can sometimes be misleading. If GPs are spending more time with their patients, that could be a good thing. This is certainly an issue that has been highlighted by the NAO, however.
	I want to deal specifically with the QOF system—the system that encourages GPs to do all sorts of things with preventive care. When the QOF system is reviewed, there is an evidence-gathering process to determine what should be incentivised in the reviewed system. On this occasion, a lot of work was done to develop ideas for addressing osteoporosis, including testing those who are most at risk, especially after the first fracture. A lot of work was also done on peripheral arterial disease and on heart failure. But what happened then? The thing that particularly frustrated GPs and many others is that the entire objective evidence-gathering process came to nothing because, at the last minute, the Government decided that the political imperative was to force through a one-size-fits-all extension of hours. That is the reality.
	An NHS Confederation briefing yesterday confirmed that the political imperative had involved increased hours and that all the evidence-based work—especially the work on osteoporosis—had gone out of the window. That is what frustrates clinicians who care about their patients more than anything. A one-size-fits-all extension of hours has now been forced through. I fully support the case for extending hours and for making access more flexible. I am sure that everyone in this Chamber finds it difficult to see their GP—because of the hours we work and the fact that we work away from home—quite apart from those on low incomes who feel anxious about taking time off work and who would like to see a GP outside normal working hours.

Sandra Gidley: I agree with my hon. Friend about the one-size-fits-all solution. One of my local surgeries deals with a lot of commuters, and it has devised a scheme whereby people can e-mail their doctor and get a response on a certain day. Often, it is not a case of needing to see a doctor so much as needing to ask a question and getting reassurance, which might not be available from someone who does not know the patient. Would my hon. Friend support more such schemes being developed in the future?

Norman Lamb: Absolutely. All sorts of innovative things are being developed. In many practices, there is a commitment to speak to a patient by telephone on the same day, if an appointment cannot be arranged. Often, a telephone consultation is just what the patient needs. We should certainly support the use of e-mail and telephone consultations. Surely it should be for local commissioners to drive through decisions on increasing hours and making access more flexible in order to meet their local needs, rather than having a one-size-fits-all solution imposed from the centre.
	I want to return briefly to the question of osteoporosis. When I asked about the loss of that valuable work at the NHS Confederation briefing yesterday, I was given an indication that there would be an announcement shortly on ways—outside the QOF system—of encouraging GPs to test for osteoporosis. I understand that there was a written statement yesterday, although I have not seen it. I would welcome an intervention from the Secretary of State to tell us what might be about to happen. We understand that an announcement is imminent. Will he tell us, either now or through the Minister of State, the hon. Member for Exeter (Mr. Bradshaw), at the end of the debate, what is proposed? A lot of people who care a lot about this matter want that work to be incentivised, because it involves good, preventive health care.
	In an earlier intervention, I challenged the Secretary of State about the fact that the GP contract often ends up paying more to GPs in the leafy suburbs than it does to those in the most deprived communities. I want first to look at the minimum practice income guarantee. The  Health Service Journal has highlighted huge variations in payment to practices, regardless of the number of patients they serve or the needs of those patients. The article highlights two practices in Westminster, one of which happens to be based at Buckingham palace. That practice gets twice as much money as it ought to, because of the minimum practice income guarantee. The article states:
	"Under the allocation formula, the Buckingham Palace practice was due to get just £14,657 this year. But the guarantee added another £16,505. That left the practice with payments of £113 for each of its 276 needs-weighted patients, compared with the sample average of £63."
	How on earth can the Government justify that system? They are paying more money to practices—often in the more affluent communities—that do not need it. As the  Health Service Journal and many others have said, that money ought surely to be used to address health inequalities.
	Another issue highlighted by the  Health Service Journal is practices excluding patients under the QOF system. I hope that the Minister will be able to respond to this when he winds up the debate. Massive variations have been highlighted, with some practices excluding 10 times more patients than the national average. As I understand it, if patients can be excluded from the QOF target, it is easier to hit the target and to get the money. There is no evidence, however, that the problem is most serious in practices that genuinely find it difficult to approach patients because they are in hard-to-reach communities. For example, Tower Hamlets and the Heart of Birmingham primary care trusts have among the lowest levels of exclusions in the country. The point made by the  Health Service Journal is that this is a misapplication of millions of pounds of public money that ought to be going towards reducing health inequalities in some of the most deprived communities.
	Overall, the highest payments under the QOF system of incentivising GPs to undertake preventive health care, which is so important to reducing health care inequalities, go to practices in leafy suburbs. How on earth can the Government justify that system? My fear about the Conservative perspective is that if we simply give all the responsibility and power to GPs, that will ultimately do nothing to change such inequalities. Ultimately, if we are to ensure that money and funding is directed to the most disadvantaged communities, there is an essential role for strong commissioning.

Rob Marris: I am grateful to the hon. Gentleman for his thoughtful speech. I think that he puts his finger on a difficulty that, if we are honest, all political parties have with these issues: on the one hand, we seem to have the shibboleth of local control and local accountability; on the other hand, we have things such as health inequalities, which we would like to address with different mechanisms. Perforce, such mechanisms are often seen as top-down control—and it seems to be another shibboleth that we should decry that sort of control. Will the hon. Gentleman explain how one does that balancing act? It is difficult for any of the three main parties to balance in their policies the top-down element, which, unlike local control, we think we do not like, bearing in mind some of the results that flow from local control—most notably displayed in the phrase "postcode lottery".

Norman Lamb: The hon. Gentleman makes a thoughtful intervention. There is, of course, the potential for conflict. Ultimately, however, our highly centrally controlled system has failed to deliver in reducing health inequalities; and all the evidence suggests, particularly if we reflect on what happens overseas, that real engagement at the local level and integrating services for health and social care with housing, community regeneration and so forth is the best way to address those underlying inequalities. Change to that extent cannot be delivered from Whitehall; it simply does not work. All the evidence from centrally controlled systems demonstrates that point. For me, then, we are more likely to achieve success if we provide genuine accountability to the communities that are served.
	The evidence that I have picked up from talking to GPs in many different parts of the country—it was reflected in what the hon. Member for South Cambridgeshire (Mr. Lansley) said earlier—suggests that practice-based commissioning is dead in the water. There is a growing frustration among GPs that all their efforts to try to make something of it and put forward innovative ideas about services that could be delivered in a community setting close to people's homes—perhaps avoiding the need for a long journey to an acute hospital—are falling on stony ground. They feel that there is no longer any political drive behind it, which has resulted in GPs becoming completely disillusioned with the concept, increasingly believing that it is going nowhere.
	Over the past few weeks, I met a group of GPs in Dorset. I noticed that the Conservative spokesman was in Poole, so I was about 10 miles up the road from there. I met another group of GPs in Norfolk last week and heard how frustrated they were about putting forward their ideas on how to develop services to the primary care trusts, yet getting no reaction at all.

Howard Stoate: The hon. Gentleman is making an intelligent point, but I have to say that I disagree with him on a number of issues. Certainly in my area, the availability of alternative community-based clinics has made a radical difference to GP referral patterns—hugely to the benefit of patients and patient satisfaction. In my practice, we do regular surveys of patient satisfaction and we have seen significant increased satisfaction as a result of patients being able to see medical people much closer to their homes and much more focused on their GP practice. In many cases, they receive care and treatment from people they personally know, which has to be an advantage. I accept that in other areas it might not be working as well, but the model itself seems to work very well.

Norman Lamb: I am encouraged to hear what the hon. Gentleman says—despite his very recent arrival in the Chamber, which I welcome. I have to say that in many parts of the country— [Interruption.] I hear a suggestion from a sedentary position that the hon. Gentleman has been saving lives, but I suspect that he was just having his lunch—[Hon. Members: "Ooh."] I do not know how much the hon. Gentleman talks to his GP colleagues around the country, but what he referred to is simply not happening in many parts of the country, where many GPs are becoming very disillusioned as a result.
	I want to say a few words about the Conservatives' over-reliance on the GP to ensure that that whole health system works effectively and in the patient's interests. The Conservative spokesman acknowledged, in response to an earlier intervention, the importance of recognising the potential for conflicts of interest, but that is absent from the Conservative motion and from most of their pronouncements. There are real concerns, including among many GPs, about potential conflicts of interest, and it cannot be said that GPs will always act in the patient's interests. One example can be seen in what I said earlier about exclusions under the QOF system. In my view, it is a dangerous game simply to believe that GPs can run the whole system. They are absolutely central to it, but their role has to be combined with strong, effective commissioning.
	This afternoon's discussion on the difference between a polyclinic and a health centre was interesting. As I said at the NHS Confederation briefing yesterday, the honest truth is that the difference amounts only to a rebadging. The Government were calling these bodies polyclinics, but they got such a bad name through what GPs and others said about them that we now call them something else. When I asked what a GP-led health centre was all about, all the things that I was told they would contain sounded very much like a polyclinic. These are, at the very least, embryonic polyclinics.

John Pugh: There is a lack of semantic clarity about the issue, as we have already seen in our debate, but one would expect the Government to know where polyclinics were. When I asked the Secretary of State
	"how many NHS polyclinics there are in England; and where each is situated",
	I received the reply:
	"The Department does not collect information about services commissioned locally by primary care trusts".—[ Official Report, 29 February 2008; Vol. 472, c. 1982W.]
	That was news to all of us; as well as not knowing what they are, it seems that we do not know where they are.

Norman Lamb: It is a state of total confusion— [Interruption.] The hon. Member for Wolverhampton, South-West (Rob Marris) talks from a sedentary position about denying centralisation, but we know that there is a central imposition of a GP-led health centre in every primary care trust. There is no option; all trusts have to introduce them. I had discussions with the East of England strategic health authority, which made it clear that every PCT must have such a centre. In the case of Norfolk, for example, I was told by the GPs I met last week that the PCT has not yet even completed its review of its estate—the buildings it owns—to ensure that it makes the most effective use of that estate. Suddenly, however, because the Government told the trust to do so, it has stopped doing that work and is now having to focus on the introduction of a polyclinic—sorry, a health centre—in Norwich.
	Introducing a centre of that sort in Norwich does nothing for rural disadvantaged people who have no access to a car and have poor public transport. It also does nothing for the greatly disadvantaged community in Thetford, which has a low income level and has a great need to improve primary care services. The imposition from Whitehall of a GP-led health centre in the centre of Norwich will do absolutely nothing for those people. That is what frustrates so many.

David Taylor: Amid the usual slurry in the Opposition motion is one nugget of gold that is worthy of note: the reference to a
	"lack of empirical and clinical evidence for... polyclinics".
	That lack is undeniable, and I raised it in Prime Minister's Question Time only a week or two ago.
	Does the hon. Gentleman hope, as I do, that the Minister who replies will provide more substantial evidence of where the concept has worked? Countries in eastern Europe and elsewhere that have used it are retreating rapidly towards our own model in order to retain doctor-patient relationships and put a distance between doctors and specialists, and to deal with other issues on which polyclinics have foundered.

Norman Lamb: The hon. Gentleman makes a good point. I believe that policy should be based on evidence. The hon. Gentleman, who is familiar with north Norfolk, will know about rural disadvantage. In disadvantaged parts of Norfolk, a polyclinic—or health centre, or whatever it is called—in Norwich will have no impact at all. As the hon. Gentleman says, we should also try to learn the lessons of experiences overseas.

David Taylor: I am grateful to the hon. Gentleman for giving way for a second and, I hope, final time.
	Although this policy may be a partial solution in London and other major cities, I do not think it will translate to rural areas and suburbia in anything like the way that the Government imagine. The same has been true of policies on, for example, housing and trust schools.

Norman Lamb: The hon. Gentleman makes another good point. I want to say more about the concept of the health centre, or polyclinic. It seems to me that such schemes should be piloted to establish how they work in given settings, so that the lessons can be learned. I think that there is something in the concept for certain communities.
	Last summer I visited the Arches centre, in a very disadvantaged part of Belfast. People in the Province have the benefit of health and social care trusts, which the Liberal Democrats support. That health centre combines various services. It brings together health and social care, and makes available to the community services that would normally be in a more remote acute hospital. That is a very attractive model. Surely we should let these centres develop and grow, and then analyse their successes and, in some cases, their failures empirically before rolling them out across the country. What I find both extraordinary and frustrating is that, without such empirical evidence-gathering, the system is being imposed throughout the country on a ludicrously tight time scale. The Government should be condemned for that.

Howard Stoate: I thank the hon. Gentleman for giving way to me again. He is being very generous with his time. Perhaps I can help him. I have a letter from the commissioning lead for one of the primary care trust consortiums in my constituency, who says precisely the same about the need for piloting. He writes:
	"The intentions of the bids are to encourage a range of pilots that will explore the potential and flexibility of the concept."
	Pilots could, he says, be
	"existing health facilities which could be adapted or expanded... on-going developments"
	or any other combination that local people decided was good for their area.
	I do not understand where the hon. Gentleman is coming from when he says that there is no flexibility and no ability to pilot. That letter makes it entirely clear that the flexibility exists.  [Interruption.]

Norman Lamb: As my hon. Friend the Member for Southport (Dr. Pugh) observes from a sedentary position, everyone is compelled to pilot. I do not consider it a pilot approach to tell every primary care trust that it must introduce a GP-led health centre.

Kevin Barron: Where does the hon. Gentleman get the evidence?

Norman Lamb: The NHS Confederation confirmed yesterday that every PCT had been so instructed, and we see the same in all the evidence. The strategic health authorities have confirmed it as well.

Mark Simmonds: Perhaps I could assist the hon. Gentleman. It was set out in a press release accompanying the Labour party's local election campaign that the Secretary of State and the Minister launched in Exeter about 10 days ago.

Norman Lamb: I am grateful to the Conservative spokesman for that information. It is of some concern that the Chair of the Select Committee on Health does not appear to know what the Government policy is.
	There seems to be a conflict in the Government's approach to the NHS. They talk of empowering patients and responding to what they really want, but when it comes to the crunch they always opt for a model imposed from the centre.

Rob Marris: The Phoenix centre—I do not know whether it is a medical centre or a health centre, but it is certainly not called a polyclinic—is just outside my constituency, and serves some of my constituents. It has been open for about three years, and provides social care as well as health services. It is so popular that, as I said earlier, it is extending its hours and its services. As far as I am aware, that model was not centrally imposed on the excellent Wolverhampton PCT, but it worked, and it will be more or less replicated elsewhere in the city because it has been so successful locally.

Norman Lamb: I entirely support that approach. As I said earlier, I should prefer a PCT that decided to adopt it to be democratically accountable to the community that it served, but I have no difficulty with the concept. What I have difficulty with is the Government's telling every PCT to complete the process by the end of the year. That appears to be the model that they are imposing.
	As I have tried to make clear, I am in favour of examining the principle. It is entirely sensible to trial the idea of taking diagnostics away from more remote acute hospitals and integrating services, and to learn lessons from the experiment. However, as was pointed out by the hon. Gentleman's colleague the hon. Member for North-West Leicestershire (David Taylor), concerns are emerging from the adoption of that approach in other countries, and those lessons should be learnt as well.
	One legitimate concern is the eventual loss of the network of local GP surgeries, about which many people will be very anxious. If this kind of model is to be adopted, I think that a rural community hospital should be used as a basis for the development of such an extended range of services. We in Norfolk are in a ludicrous position. We face the loss of a community hospital in Aylsham, a market town, and we are seeing the loss of beds in other community hospitals. Surely we should develop existing, trusted centres of excellence and take the consultants out of acute hospitals, ending the divide between primary and secondary care and providing genuine local care for those who need it.
	I want to say a word about the Conservatives. I think there is a degree of hypocrisy in their complaint about central control. They have conveyed the clear message that they dislike the degree of central control exercised by the present Government, yet they propose to introduce a CSA-style unaccountable quango, presumably based in London, to direct the national health service. The Child Support Agency is rather unpopular, and I suspect that when people find that their local hospital is to be closed by a centralised unaccountable quango in London, they will regard it much as they regard the CSA. There is no democratic local accountability in that, and the Conservatives know it. They reject this model, and decide instead to retain the idea of a centralised system. That is even worse than the Government's approach, which at least involves some democratic input in the House.
	The Conservatives' approach is to opt for a centralised quango that does not even have any accountability to this place. It is supposed to have discussions with the Secretary of State before it decides what to do, but it is clear from the powers of this body that the Conservatives seek to establish— [Interruption.] The hon. Member for Mid-Bedfordshire (Mrs. Dorries) may not like to hear what the Conservatives are proposing, but the fact is that a centralised quango will have extensive powers over commissioning and determining what should happen at local level, and people will not like that if they have to deal with it.
	The motion is right to address the Government's excessive emphasis on central control. I challenge the Government to provide genuine accountability for local communities, as the Liberal Democrats propose. I also urge the Secretary of State to listen to the concerns of general practitioners. The model that we should choose is democratic local accountability on the shape of health services serving a community. Alongside that, we should free up GPs and health professionals to do the job that they are qualified to do without overly controlling them from Whitehall.

Nadine Dorries: I wish to start by paying tribute to GP Professor Dr. Brian McGuinness who retired this week as the chairman of the Society of Medical Writers. He is plain old Dr. McGuinness to me and he epitomises the type of GP that we all talk about. He was the ultimate family GP. I have not seen him for about 20 years, but he established one of the first large GP practices that I was aware of, in a socially deprived area in the north-west. That practice encompassed many of the services that we have been talking about with regard to polyclinics. His practice was not a polyclinic—it did not have a fancy title—but it was a good practice providing a good service to the local community, commensurate with its needs.
	The practice had a good patients forum that met regularly and advised the GPs—many GPs do take advice from patients and local patient groups. The practice had seven or eight GPs and provided adequate services to the local community and was well respected. Dr. McGuinness was possibly one of the most highly regarded GPs I have ever known, especially in the socially deprived area in which he practised. He recently received a lifetime achievement award, but it is to his credit that he has vowed to continue to work to encourage GPs and other medics to write about their experiences. I therefore begin by paying tribute to GP Professor Dr. Brian McGuinness, who is one of the best of men as well as one of the best doctors I have ever encountered.
	In preparation for this debate, I spoke to some of my local GPs and I want to feed back some of the comments that they made. As their MP, my job is to represent the opinion of all my constituents, and my GPs have some very strong opinions about what is happening and the Government's proposals. They are unanimous in being incredibly angry and they feel undermined and persecuted by the Government. It all stems from the much spun pay rise that GPs received in 2004. It is very rarely mentioned that that pay rise brought GPs' pay to an acceptable level, given their training, experience, commitment and hours. Before the pay rise, GPs were one of the lowest paid professions, so it was right to give them that pay rise and bring their pay to that level.
	I would not be surprised if the Department of Health had a unit solely devoted to spinning against GPs. We have seen some ludicrous headlines in the tabloids recently, but they did not dream them up. They did not come from GPs either. Those headlines were spun somewhere in the Department of Health. It was preposterous to have stories about GPs earning £250,000 on the front page of national newspapers, and that did GPs no good. As I said when I intervened on the Secretary of State earlier, GPs represent the most cost-effective and efficient branch of the health service. They cost £20 per consultation, even for long consultations.
	As I said, the 2004 pay rise brought GPs pay to a reasonable level. Since then, they have had a 0 per cent. pay rise for three years. Which other profession would put up with having a pay rise that just brought them back into line with what they should have been earning, followed by a pay freeze in the next three years?

Kevin Barron: A recent report by the National Audit Office said that in real terms partnership GPs have had a 50 per cent. increase in the past three years. Does the hon. Lady think that that is bad?

Nadine Dorries: I have absolutely no idea where that figure comes from. My GPs have had no pay rise for the past three years, at the same time as their staffing costs have increased by an average of 5 per cent.

Andrew Lansley: For the sake of accuracy, I wish to point out that the NAO said that there had been a 58 per cent. increase over three years from 2002-03 to 2005-06. My hon. Friend is making a point about what has happened since 2005-06. The return of doctors to general practice has remained the same, but costs have risen. The position has changed since 2005-06, and we do not have the figures yet.

Nadine Dorries: I specifically referred to the past three years. Staffing costs have increased for general practice, and the front of this week's  GP, the GPs' magazine, reveals that some GP practices could face a 10-year pay freeze. So not all GP practices' finances are rosy, and GPs are feeling persecuted and undermined by the Government. Morale is very low.
	One result of the pay rise was a rebalancing of GPs' morale, but there was also an easing in recruitment. It became easier to recruit on to the GP training scheme and to recruit new GPs. However, over the past few years, that has suddenly and dramatically changed and it is again becoming difficult to recruit. Just in my constituency, I know of GPs who are leaving general practice to go to New Zealand or the US, because of the demoralisation and confusion about the future of the service that GPs are beginning to feel.
	Patients want, above all else, the stability and continuity of having access to a GP whom they know and with whom they have built up a relationship. They want to have confidence in their GP, especially if they have a difficult illness or are elderly. GPs work on the relationship with their patients because they know the value of having a good relationship with them, including an element of confidence. Polyclinics will probably include Australian or other antipodean doctors, or Polish doctors. They will come and staff the clinic for six months, probably as part of their travels, and then move on. The relationship that patients have with their GPs will no longer exist.
	GPs are leaving the service at the moment, so I would like to know how the polyclinics that the Government propose will be staffed. Where will the GPs come from? Many GPs want to retain the service that they provide to their communities, because that is what patients want. Patients do not want polyclinics. As the end users of the service, patients must have a voice in deciding what will be provided. GPs must also have a voice in what they are going to provide. By and large, they do not want large polyclinics.
	In rural constituencies such as mine, with a high elderly population and poor transport links, it is preposterous to suggest that people will be able to get on a bus and travel to a polyclinic. Bus services have been cut dramatically in the past two years, so they will be unable to get a bus to a polyclinic, wherever it might be. It is also likely that such a clinic would be in Bedford or the outer areas of that town, but only 12 per cent. of my constituency is built on, as it is a rural area. It would be extremely difficult for my constituents to get to a polyclinic.
	Another problem is staffing. More GPs are leaving the profession than are arriving. Which services will be offered in the polyclinics? If radiography services and other physiotherapy services are to be carried out in polyclinics, who will carry them out in hospitals? Hospitals are already finding recruitment difficult. If a radiographer is out in a polyclinic, who will be in the hospital?

Stewart Jackson: My hon. Friend is making a compelling case. Surely the logical corollary of her argument is that any general practitioner in a family practice that is doing well will not want to move to a polyclinic. As there are shortages of fully trained medical practitioners in many parts of the country, will not the system embed second-class health care at polyclinics for some of the most vulnerable people in our communities?

Nadine Dorries: My hon. Friend is absolutely right. The polyclinics will take off in the areas of higher social deprivation where, because of the transient nature of those who will work in those polyclinics and the problems in various hospitals, such as Peterborough, we will see a lesser service on offer rather than a better one. GPs who can combine—like those in the example from Macclesfield that we were given—will do so if it is what the community wants, desires and needs. If it is cost-effective and serves the community better, nothing stops GPs getting together now to provide such services. Many GP practices already do that so there is no barrier to the essence of a polyclinic; GPs can provide that service if their patients need it.
	I hope that the Minister will clarify those services that a polyclinic will provide better to a community than those that GPs have the freedom to provide now. What is this magic bullet represented by a polyclinic? What will it do that GPs cannot do today?

Howard Stoate: I can help the hon. Lady on that point. One thing that polyclinics will do, for example, is to be open 12 hours a day, seven days a week. Virtually no GP practices are open for such hours. Secondly, polyclinics will provide services such as radiography, blood testing, ECGs and all sorts of facilities that are not available in the vast majority of GP practices—nor are they likely to be. Polyclinics are a model that will, we hope, keep patients away from acute hospitals and prevent long queues forming in accident and emergency made up of people who have no need to be there. They will enable those people to be looked after in a much more comfortable setting much closer to their home. On the transport issue raised by the hon. Lady, people will travel on average far shorter distances to reach such services than they have to under the district general hospital model.

Nadine Dorries: The hon. Gentleman makes a number of points. The only reason why we see pressures on accident and emergency services at the moment is that cottage hospitals and community hospitals are being closed down. As for 12-hour practices, I have had no letters in my postbag on that subject and no constituents coming to my surgeries to say, "I wish my doctors' surgery was open for 12 hours a day." It is unreasonable to expect GP surgeries to open for 12 hours a day, if we have good local facilities provided by the PCT.
	Let me give the hon. Gentleman an example. A GP recently told me of a PCT manager who got very stroppy with him in his surgery, because the GP had seen a patient who had been out of hospital for 10 days after a post-partum haemorrhage in hospital, and who went to his surgery and complained of chest pains and a pain in the leg. She was a very poorly lady. The GP immediately thought that that could be a pulmonary embolism, did the right thing and sent her to hospital. He was then criticised by the PCT for doing so, when any GP anywhere would do the same in such circumstances, polyclinic or no polyclinic. When a GP sees a patient with acute needs, such as chest pains, he saves the PCT that £3,000 admission fee, because many GPs will diagnose and treat in their surgery as far as possible before sending a patient to hospital.
	I do not see polyclinics as filling a need because I do not think that the need is there. GPs provide an excellent service; they save PCTs a huge amount of money; and they are incredibly cost-effective. Patients like the service. They like having a local GP. GPs enjoy building up a good relationship with their patients, so why, if it is not broken, do we need to fix it? That is what I do not understand.
	In areas such as Macclesfield, where we need such services, we have provided them. What is the image of the polyclinic? Why are we imposing such a service on communities? Why are we making it more difficult for patients? Why are we imposing something that doctors do not want?
	On the point about blood counts, can anyone show me a GP who does not take blood tests and send them on to a hospital lab? A GP who does not do that in his practice should not be a GP. Many GPs provide that service—I have never heard of one who does not. Can anyone show me a GP who does not refer on for radiography or who does not provide the test? They have those services at their fingertips if they need them.

Andrew Lansley: New technology offers other opportunities. Clearly, the hon. Member for Dartford (Dr. Stoate) might not be aware of the pilot scheme in Lancashire whereby GPs' surgeries can send ECGs to a centre in Manchester where trained cardiac nurses interpret them on their behalf. They do not need the patients to go to a single place. Local GPs are perfectly capable of carrying out 12-lead ECGs and sending them off for remote interpretation.

Nadine Dorries: I know many GPs are capable of doing 12-lead ECGs and of reading the results themselves, because they have trained to be able to do so, as well as sending them off to the cardiac nurses. I do not understand the need for polyclinics, but I do understand that GPs are not happy. Patients do not understand the need for polyclinics. In fact, nobody understands why the Government are doing this. The system is not broken, so why are the Government trying to impose this change unless they are trying to save costs in some way?
	In conclusion, I have voiced the concerns of my GPs and patients, who are happy with long-established GPs in my constituency. They do not want a polyclinic. They like what they have at the moment. If they were to have anything, they would want greater resources to be given to GPs so that they could extend the services that they currently offer. They do not want a centralised polyclinic to which they would have to travel, particularly in Bedfordshire.

Richard Taylor: After that cogitation, I am grateful to have been called to speak, Mr. Deputy Speaker.
	I was encouraged when the Secretary of State sat down and since then I have become more and more depressed. I was delighted that he acknowledged the quality of our family doctor services, and that he acknowledged the crucial importance of the strong ties between GPs and their patients and their families. I welcome the extra money and his clear statement that there are no plans to herd GPs willy-nilly into polyclinics, whether they want them or not, and that it is not a top-down measure.
	We all know from our PCTs that they have been told that they must have a polyclinic. I am sorry that the Minister is not here at this moment, because I want him to confirm that I can go back to my PCT and say that the Secretary of State has said that if the trust can provide the same sort of services that a polyclinic would have provided in the enlarged health centres, which it has planned according to local need and with the money that has been provided for that purpose, the polyclinic will not be imposed on that trust.
	I am delighted to see that the Minister is back. I hope that he has got the gist.

Stewart Jackson: I am grateful to the hon. Gentleman. I was privileged to serve with him on the Select Committee on Health, of which he is a distinguished member. Is his experience the same as mine? My city council's health and scrutiny committee has been given the health centre/polyclinic as a fait accompli, with the caveat that it will be placed in an area of social deprivation in my constituency. Effectively, the committee can do nothing about that decision except rubber stamp it.

Richard Taylor: I have absolutely no objection to siting these facilities, whatever they are called, in areas where they are needed. I just want to be able to tell my local PCT that it is up to it to decide what is best for the local area.
	My real worry about polyclinics is that they could open the door to commercialisation. The hon. Member for St. Ives (Andrew George) touched on that problem in an earlier intervention, but I want to look at it in a bit more detail. People often ask what all the fuss is about, and a letter in my local paper, the  Worcester News, carried the headline "Just what point are GPs trying to make?" The letter stated:
	"Let me try to understand. They are, apparently, totally opposed to the "privatisation" of general practice—yet, of course, the private sector is precisely where they themselves work and earn their crust!"
	I was rather disappointed by a document distributed at yesterday's NHS Confederation briefing. Headed "Privatisation and reduced quality", it stated:
	"There is concern that opening up contracts to the private sector will have an adverse impact on quality and that there is not a level playing field between the private sector and incumbent GPs. However, this seems to ignore the fact that GP practices are independent for-profit contractors already."
	The most effective response to that approach comes from the pressure group "Keep Our NHS Public". It is not a rabid, left-wing group: its members are highly dedicated professionals who are passionate supporters of the NHS, through and through, and I shall paraphrase some of the points that they make.
	The group accepts that GPs are independent contractors, but asserts that they are crucially different from the large corporations that stand ready to compete for the provision of health services. It says that GPs know their patients and are driven by local priorities—exactly what the Secretary of State said when he acknowledged the value of the relationship between GPs and local families. The group believes that profits for shareholders drive the private corporations, and that those corporations will decide which patients to treat and which services to offer.
	The pressure group believes that professional judgment can be overridden by company policy, and that governance and the monitoring of standards of care could be impeded by commercial confidentiality. It also says that the skill mix may be downgraded, and that NHS pay, conditions of service and pensions might not be retained. I believe that such warnings about the dangers of commercialisation need to be taken very seriously, and in that regard I commend to Ministers two seminal articles that have been published recently.
	The first article appeared in the  British Medical Journal, and it looked at the US experience of competition in the health care system. It said that the US has long combined public funding with private health care management and delivery. It noted that extensive research had found that the US for-profit health institutions provide inferior care at inflated prices, and that the US experience shows that market mechanisms undermine medical institutions that are unable—or unwilling—to tailor care to profitability. Finally, the article said that the poor performance of US health care is directly attributable to reliance on market mechanisms and for-profit firms, and that it should serve to warn other nations from following that path.
	The second article was published in the  New England Journal of Medicine, which is highly respected in this country. It states:
	"The extreme failure of the US to contain medical costs results primarily from our unique, pervasive commercialisation ...Medicine...does not lend itself to market discipline."
	The article describes in detail the cost-containment tactics and false economies that commercial organisations plan, and it also looks at revenue-maximisation strategies, the concentration on lucrative procedures and the selection of risk. It even pays a tribute to the British system, saying:
	"When the British NHS faced a shortage of primary care doctors, it adjusted pay schedules and added incentives for high-quality care, and the shortage diminished. Our commercialised system seems incapable of producing that result."
	The article ends with the observation:
	"Sometimes we Americans do the right thing only after exhausting all other alternatives. It remains to be seen how much exhaustion the health care system will suffer before we turn to national health insurance."
	That worry has been reinforced by at least one whistleblower, who was reported in  The Guardian on 9 April. I have seen the papers involved, which I think that he probably sent to all members of the Health Committee. They were very long and complicated, so I do not blame any colleague who has not read them through, but the man who provided them has seen the lengths to which organisations that want to break into the market will go to enhance profits. I am reminded of the recent revelations about how a drug manufacturer went to unethical lengths to prolong the life of one of its proprietary drugs that was long out of patent.
	I have the marvellous privilege of being able to choose how to vote at the end of this debate, but my problem is that I do not know whether to support the motion or the amendment. That terrible quandary arises because I am not completely sure that the NHS as I have known it for years will be entirely safe under either of the two main parties. I do not yet know how I shall decide to vote, but my voting record would suffer if I did not support either proposition.
	I welcome much of what the Government have done for the NHS. I appreciate the extra money that they have provided and the way that they have handled the service, but I hope that they will look very seriously at the warnings that I have repeated about the dangers of opening up family doctor services to commercialisation.
	However, I am also worried about the Conservatives. We all know the proverb about how difficult it is for a leopard to change its spots, but it has a corollary—that even when a leopard does change its spots, it remains rather proud of having had them. The changes to the NHS made by the previous Tory Government included the introduction of market forces, the purchaser-provider split and the private finance initiative. I therefore cannot quite accept that any future Conservative Government would oppose the commercialisation that I strongly believe is not welcome in general practice.

Howard Stoate: First, may I apologise to you, Mr. Deputy Speaker, for not being in my place at the start of the debate? I had a meeting with the Prime Minister, but one of the issues that I raised with him was the proposal on polyclinics, so at least that was relevant to this discussion.
	As many hon. Members will know, I am a practising GP, something that I hope will enable me to make a constructive contribution. It will be of no surprise to the House if I say that I speak to an awful lot of GPs around the country. Many of them are concerned about what the polyclinic model might lead to, and worried about how it might affect their practices and patients. I therefore think that it will help the House if I set out what I see as the vision for this type of health care.
	I envisage a mechanism whereby people can be treated far closer to their own homes, with far less reliance on public transport, far shorter queues and much less reliance on accident and emergency departments, which are often inappropriate places for people to go with many health care needs. They are often not seen by the most appropriate person in the department, and in many cases it is not the nicest place to be. A and E departments simply become clogged up, which often gets in the way of the serious, life-saving work that they need to do. The last thing that they need is a group of patients coming to the A and E who would be far more appropriately treated by their GP practice, district nurse or pharmacist, in a setting that would be far better for their health care.
	It is important to set out exactly what the polyclinic model is intended to do. The hon. Member for Mid-Bedfordshire (Mrs. Dorries) said that there is nothing that a polyclinic can provide that cannot be provided by a GP service. I am sorry that she is not currently in her place. The fact is that a polyclinic or such a model could offer a huge number of services that currently cannot be made available in GP services. An obvious example is X-rays. The hon. Member for South Cambridgeshire (Mr. Lansley) made the point that ECGs can be sent online. Of course they can, and of course blood tests can be taken in GP practices. However, it is much more difficult for a GP practice to have an X-ray or ultrasound department with the necessary scanning equipment and range of health care professionals. That is well beyond the scope of current general practice, and we need a radically new way of deciding how those facilities should be produced.
	When I ask my patients what they want, they say that they want to be treated as near to their homes as possible, hopefully by people whom they know, trust and have had dealings with before. They do not want to go and sit in a crowded, noisy hospital among patients who clearly have far greater health needs and therefore should obviously take priority. The polyclinic model is a good example of how we can transform the patient experience.
	Another obvious example of why the system might work is that it is currently estimated that every time somebody walks into A and E, it costs the health service about £150. A GP consultation costs about £20, so we can immediately see that anybody who attends their GP surgery instead of going to A and E will lead to a dramatic saving in health care expenditure, which could therefore be targeted better than by spending it on A and E. Obviously a polyclinic would have extra fixed costs and there would be other services to consider, but it would still mean a significant cost saving compared with people going to A and E, and it would therefore leave far more money for investment in NHS services and for better use in patient care.
	The NHS has moved on. Clinical practice is evolving all the time, and patients' expectations are changing. When I first entered general practice, people almost always had surgery as in-patients in hospital. They often stayed in hospital for several days, or even weeks. Now, 70 to 80 per cent. of all surgery is day surgery. The idea of relying on large, impersonal hospitals is a model that has outgrown its usefulness, and we need to move on to a much more flexible and modern approach. I believe that polyclinics, rather than diminish the range of services and choice, will increase it.
	The myth that goes around that if a polyclinic is set up, patients will no longer have a choice of GP, is clearly rubbish. Under the patient choice directive, patients will be able to request a specific GP. Provided that that GP is on duty, that it is reasonable and that he or she has the available appointments, the patient will be able to specify that GP. It does not have to be impersonal. In fact, the model that I read out in an earlier intervention will, in many cases, be based around existing practices, which could be significantly extended or developed to add the extra services that are not currently available, albeit with extra funding and resourcing.
	Another advantage of polyclinics is that they will allow GPs, acute specialists and other health professionals such as pharmacists to work together for the first time. General practice can often be isolating, and in small, isolated practices it is often quite difficult to have the mix of colleagues and clinical expertise that is required for personal and professional development.
	I am aware that time is pressing on, so I do not wish to go on too long, but I wish briefly to quote Mr. Anthony McKeever, the chief executive of the care trust in Bexley, where my practice is situated. I wrote to him recently to ask what the PCT's model of polyclinics was. He stated:
	"We do not intend to create polyclinics on the assumption that 'one size would fit all'...A couple of local practices have indicated that they would like actively to explore the possibilities of providing a more integrated care landscape...So, there will be plenty of opportunity to avoid the pitfalls which some anticipate...Certainly, however, the GPs I spoke to direct recognised that the development of primary care 'hubs' or polyclinics could be achieved without damaging and unintended consequences."
	As far as I can see, that is the chief executive of a PCT being sensible and pragmatic and understanding that flexibility is perfectly acceptable under the Government's plans, and who actively wishes to work with local GP practices to ensure that what actually happens is a huge improvement in patient care outcomes. Hopefully, that is what we are all aiming for.

Stewart Jackson: It is a pleasure to follow the hon. Member for Dartford (Dr. Stoate), with whom I served on the Select Committee on Health.
	I should like to make a few general points about family doctor services. That is the subject of the debate; it is not just about health centres and polyclinics. At the kernel of the debate is a question of honesty and integrity on the part of the Government. I do not believe that they have made the case transparently and openly for a Kaiser Permanente, California model of private sector health provision. They know full well that were they to make that case, they would not get it past their own parliamentary party, the health sector trade unions or other health care professionals. There may be merit in their model, but at the moment we are not having an honest debate about it. It is incumbent upon the Government to put their cards on the table and make the case for polyclinics or health centres.
	It is ironic that the Secretary of State was in crowing mood. As I said earlier, we always see the vacuity of the Labour party's record and arguments on the health sector when it has to go back 60 years, to historic documents about what was or was not said by general practitioners and medical practitioners in 1947. The fact is that this Government have presided over a doubling of expenditure on the health service but barely any change in outputs and the impact on patients. Their work force planning was described in the Select Committee's report last year as "disastrous". The right hon. Member for Rother Valley (Mr. Barron) was noticeably shy in not sharing that with the House.
	The Government have presided over a health service in which one is more likely to die of a hospital-acquired infection than, for instance, in a road traffic accident. They will have spent approximately £100 billion on the health service, and we will not take any lectures from a Government who, for example, have increased GP salaries by 50 per cent. for less work. I do not blame the general practitioners for that; it is this Government's cack-handed mismanagement that has resulted in that situation.
	I well remember that the then Prime Minister came to Peterborough in April 2000 to open the walk-in centre in Midgate, in the city centre. Such centres were then the great thing, the next big thing of Labour's Maoist onward march of health reform. They were going to solve all the problems and take up the slack in the primary care sector. Of course, they are not in fashion now, so we have even more change.
	My opposition to the scheme is not a knee-jerk opposition to change. Dare I say it, I am quite Fabian in my approach—I believe in the inevitability of gradualism. In such a big organisation, there will always be change, but I object to the top-down approach of the change and the fact that there is no real autonomy, authority or democracy in respect of general practitioners, health care professionals, nurses, managers, elected councillors and others at local level. The change is being imposed. That is to be regretted—a point made by Members across the House.
	General practitioners in particular need to be properly consulted; they need buy-in to the new health centres or polyclinics. It is no good the Secretary of State, in his rather uncharacteristically sneering remarks, belittling the work of GPs, who are the most trusted health care professionals in the UK—perhaps the only point in my speech with which the hon. Member for Dartford will agree. It ill behoves the Secretary of State to take that confrontational tone, and it is no wonder that such a significant number of GPs are not predisposed to vote Labour at the next general election.
	I want to give the House a slight history lesson about primary care in the city of Peterborough. The city pioneered collaboration between adult social care and primary care, which the Liberal Democrat spokesman, the hon. Member for North Norfolk (Norman Lamb), described as an exemplar for the country. If I may, briefly, be positive, one of the only aspects of the Government's health policy with which I agree was that they listened to us about Peterborough's primary care reorganisation in 2005. We in Peterborough said that as we had pioneered collaboration between adult social care and primary care it would be ludicrous to throw it away in an unpopular and uncalled-for reorganisation. The Government listened, and the former Secretary of State, the right hon. Member for Leicester, West (Ms Hewitt), threw out the plans.
	There were other reasons why we insisted that we should have a city-wide health care body or primary care trust. We in Peterborough have specific health needs and health inequalities. Even in a relatively small area such as Cambridgeshire there is a great gulf between the needs of my constituents and, for instance, those in a relatively wealthy constituency such as Cambridge. We have issues around asthma, chronic obstructive pulmonary disorder, diabetes and heart disease. We have a large ethnic minority population who are predisposed to some chronic conditions. We felt that to be subsumed into a greater Cambridgeshire PCT was not appropriate—the fact that the trust was approximately £30 million in deficit at the time concentrated our minds somewhat, too. The Government listened, and we went forward.
	I pay tribute to the PCT in Peterborough and the professionals who work in the organisation, especially Angela Bailey, the chief executive. However, when I read the proposals and listen to the Secretary of State, I am astonished that a Government who exult in the fact that the NHS is 60 years old and that they were responsible for founding the national health service could really be presiding over changes that would give the sickest, the very oldest, the very youngest and the poorest—the least able to speak up for themselves—a second-class primary health care system. As I said earlier, I cannot believe that of a Government who seem to be having a nervous breakdown in their interaction with those who should be their core supporters. We know that the Labour party has always had a rather sanctimonious, smug attitude—only Labour cares about public health, the poorest people in our society and the health service. Of course, that has never, ever been true.

Nicholas Winterton: In an area such as Macclesfield, which I represent, where there is an out-of-hours service staffed by GPs at the district general hospital and where all the GP practices in the town came together, with the agreement of the PCT, in a super-surgery to provide the wide range of facilities that the hon. Member for Dartford (Dr. Stoate) described, does my hon. Friend agree that it should be the PCT that takes the decision and not central Government?

Stewart Jackson: I am grateful to my hon. Friend for making the pertinent point, alluding to his constituency, that where we trust NHS professionals and give them authority, autonomy and budgets, they will work for their benefit and the benefit of patients and the whole community. We can see an example of that co-operative work in the primary care sector in Cheshire, particularly in Macclesfield. I pay tribute to my hon. Friend for his role in producing that outcome.
	As of March 2009, a polyclinic or health centre, or whatever it is to be called, will be foisted on my constituents in Peterborough, with only partial lip service to democracy—the gloss of democracy—via the city council health overview and scrutiny committee. What is the strange beast that will be foisted on us? Open 12 hours a day, seven days a week, it will apparently provide a one-stop, multidisciplinary medical assessment, diagnosis and treatment facility, supposedly located in a deprived area of the city. All fine and dandy in principle, but what does one-stop medicine actually mean? Where will the doctors to staff the polyclinic come from? No established doctor who has his or her own family practice will want to give it up to work at a polyclinic. Does that mean that less experienced and capable staff will be recruited? I hope not. When we board an aeroplane we hope it will be flown by a pilot, not an air stewardess. I hope that when my constituents go to a polyclinic they will receive the highest possible standard of primary care from clinicians and NHS professionals.
	We have already seen shortages across the country—for example, of fully trained radiographers, as my hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries) said, and of specialist nurses and hospital doctors. What about X-rays, scans and blood tests? Will there be consultants on site to oversee such work? If so, who will cover their work at Peterborough district hospital and Edith Cavell hospital? What are the resource implications?
	Will polyclinics deal only with straightforward cases, such as the young, the wealthy and the only occasionally poorly—Tarquin and Jocasta popping down in their 4x4 before they go off on a business trip? Will polyclinics treat only the so-called worrying well? That may be the case. What about the very old, the poor and people with chronic conditions, such as chronic mental health issues? Will they be welcome at the polyclinic? I am not entirely convinced.
	What will be the future of the family doctor service in my constituency? Will those services go the way of local shops and pharmacies? Mention was made earlier of the impact of the 2005 regulations on small pharmacies, which are closing at an alarming rate, giving way to the provision of pharmaceutical services in large supermarkets such as Sainsbury's and Asda. Will those services go the way of NHS dental surgeries and of post offices? We know of the Government's lamentable record of duplicity about post office closures over a number of months and years.
	The Department of Health has promised more money for polyclinics, but will it be from existing, struggling NHS local budgets? I beg the indulgence of the House while I make my next point—one with which my hon. Friend the Member for Boston and Skegness (Mark Simmonds) will have some sympathy. We have had a huge influx of EU migration in Peterborough that has put massive strain on surgeries across the city, notably the surgery of Drs. Modha and Modha at Thistlemoor road, New England, and Dr. Prasad's surgery at the Westwood clinic. They are straining under the weight of inward migration from the EU. Will that be taken into account in the national template forced on local PCTs? No one in Peterborough has voted to end the relationship between patients and their local, trusted and—mostly—friendly general practitioners for the sake of those super-surgeries.
	We should be opening more family practitioner surgeries in the poorest areas of my constituency. We should not be centralising and putting everything in one place—a place that people who have travel and transportation problems as a result of their illnesses and medical conditions may find it difficult to reach. As always happens under this Government, there will probably end up being a great fanfare and lots of money spent, but at the end of the day there will be depersonalised services, dumbed-down care and a system without comprehensive budgeting, risk assessment or proper consultation.

Graham Stuart: I apologise for my late return to the debate. I wonder whether my hon. Friend agrees that we may end up with another situation that often arises under this Government. Government Members are fighting against their own tax rates, and Government Members who have voted to close post offices are leading campaigns to protect their local post offices. Does my hon. Friend believe that we will see Labour Members leading protests against the closure of family practices, even though they will doubtless vote for those closures later this afternoon, having had yet another loss of conscience?

Stewart Jackson: Labour Members of Parliament, who are in a weird parallel universe with the Prime Minister, voted against a Conservative motion on post offices in the Lobby, and then ran hotfoot to their constituencies to address public meetings, in which they said how hard they were working to keep post offices open, having issued press releases and put them on their websites. I am an old cynic, but I foresee occasions when my Labour opponent will be fighting tooth and claw to protect surgeries that his own Government have led to be closed.
	My admiration for local NHS staff is well known, and we are fortunate to have good managers in our area, but my job as a Member of Parliament is to stick up for the people in my constituency who do not have a voice, and to ask awkward questions. I will continue to ask those questions until we have full, honest and transparent answers from the Government on polyclinics, and until we concentrate on the really important issues—on making the whole of our communities better—instead of on gimmicks that will lead to disaster.

Kevin Barron: I declare an interest: I am a lay member of the General Medical Council. First, I want to reply to a comment made by the hon. Member for Wyre Forest (Dr. Taylor) about clinical judgment being superseded by the needs of a company—I think that he was quoting from the NHS campaign group, Keep Our NHS Public. In all my years on the GMC, that has not happened. People who work in the independent sector come before the GMC from time to time, but I have never met anyone in the medical profession who felt that they would have to do something that was against their clinical judgment; that would be wholly wrong and unprofessional. We may argue about one pharmaceutical prescription as opposed to another, but I do not see any proposals that would endanger the patient.
	The hon. Member for Peterborough (Mr. Jackson) was a member of the Select Committee on Health a few months ago. We criticised the national health service, and therefore the Government, on work force planning. That is absolutely right. As most people in the national health service would agree, work force planning has been dysfunctional for a long time now. That situation is beginning to get a little bit better—I am pleased about that, and I hope that the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw), is, too—but it in no way threatens family doctor services.
	I point out to my hon. Friend the Minister that family doctor services have been the backbone of the NHS for the vast majority of our constituents since 1948, and will remain so. It is true to say that those services are not always the first port of call. The hon. Member for Romsey (Sandra Gidley) would probably jump up and tell us that our constituents' first port of call for health care help and professional advice is the local pharmacist, and not the local GP; that will remain the case. The vast majority of doctors who work in family care services are committed to their flock—their patients in the community where they practise. I have no doubt about that, and I do not feel that they are under threat in any way.
	Let me say why I do not support the Opposition motion and why I support the Government amendment. In their changes, the Government are investing an extra £250 million to establish more than 250 new primary care services, which will include both GP-run health centres and GP practices. Some 113 of them will be established in some of the most deprived communities in the country which have historically been under-doctored. There will be 152 new state of the art GP-led health centres, which will be open between 8 am and 8 pm, seven days a week. One such structure will be built in a constituency that neighbours mine, but it will serve my constituents well. Those health centres will offer a wide range of health services, including pre-bookable GP appointments and walk-in services for registered and non-registered patients, and a range of specialist services.
	I had discussions last September with the local foundation trust. It will bid to provide some of the services that will be offered in the new primary care centre, as we will call it in Rotherham. Those services may not be offered in the district general hospital. Particularly for those who do not have their own transport, it is a lot easier to go to the town centre by bus than it is to get to the local hospital, so it will be a great advantage to urban Rotherham to have that facility, which will be open seven days a week, 12 hours a day.

Peter Bone: Has the Chairman of the Select Committee had a lot of people in his area writing letters or coming to his advice surgery to demand those extra hours—the Saturday and Sunday service, and for services to be open 12 hours a day? Has there been a lot of demand for that?

Kevin Barron: No, there has not; that is the true and honest answer to the question. Around the time of the last general election, there were problems with the way in which one practice near my constituency office interpreted the 48-hour rule that was introduced a few years ago. That was the only time that anything was said about the health service at the time of the general election. People were upset that they had to phone in the morning for an appointment that day—an impossible task, particularly for people who work and people with young families. I thought that that was a gross misinterpretation of the agreement, and so did the primary care trust. It had to try to negotiate with the GP practice on whether it would relax its strict interpretation of the rule and free-up access in a reasonable way. We were not talking about opening the practice seven days a week, 12 hours a day; we just wanted to free-up access in a reasonable way, so that people who were on that family doctor services list could get seen in a more reasonable time. That was a complaint about one surgery; there were no complaints about the many other GP surgeries in my constituency.

Howard Stoate: Perhaps I can help my right hon. Friend. The issue is not so much about the number of people who demand such services when they are well as it is about the number of people who are using accident and emergency departments on a Saturday and Sunday, but who would far rather be seen in their local clinic, a bus ride away, by their local GP, pharmacist or practice nurse. The real benefit of opening 12 hours a day, seven days a week, is far more to do with keeping people away from accident and emergency departments—many of which may be 10 or 20 miles away, or even more—that are inappropriate for them. We should localise the care that is appropriate to their needs, so that it is far closer to their homes.

Kevin Barron: I agree. The question posed in the motion, and asked by the hon. Member for South Cambridgeshire (Mr. Lansley), is what about walk-in centres. Our walk-in centre in Rotherham will close. It is based in a pretty old building that used to be a hospital. It is not an acute hospital now, although services such as podiatry are based there. People will instead go to the new primary health care centre—we are not calling it a polyclinic—that will be built in Rotherham. I had an e-mail from the primary care trust earlier this week saying that there will be two new GP practices in there. Those practices will not be transferred; they will be new. It also said that local GPs who want to bid for that contract will have the right to do so. Family doctor services could even expand if they are successful in obtaining an NHS contract to provide that type of service in the Rotherham primary care centre. We should recognise that no matter who runs such centres, those are national health service contracts designed to provide better services for our constituents.

Nicholas Winterton: I am grateful to the current Chairman of the Health Committee, which I had the honour to chair in the past, for giving way. Will he say to the House that polyclinics should not be forced upon areas where there is already adequate cover by way of out-of-hours services, staffed by local GPs—in my case, as I said in an earlier intervention, at the district general hospital? In Macclesfield all the GPs' services have come together in an excellent super-surgery, where they operate separately as individual practices, which is so important to people. Is it not right that a polyclinic should not be forced on areas where there is already adequate coverage?

Kevin Barron: The hon. Gentleman is not the first to cite that example. His better half, the hon. Member for Congleton (Ann Winterton), mentioned family doctor services in Macclesfield earlier. There is and always has been the flexibility in the national health service for that to happen. The question is whether it does. I shall come to that.

Graham Stuart: I know that the right hon. Gentleman shares my concern about provision in rural areas. There is, as my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton) observed, a fear about the imposition of polyclinics. The policy will go down particularly ill in rural areas where minor injuries units in community hospitals have been shut down or had their hours massively reduced. If Ministers suddenly espouse the need for provision 12 hours a day, seven days a week, people in those communities will not understand why that has been removed from community hospitals throughout the country, and they will not believe that the policy is likely to lead to the improvement in rural areas that the right hon. Gentleman implies will happen.

Kevin Barron: I am no expert on the hon. Gentleman's constituency but, as was said earlier, and not by me, there is and should be flexibility. It might be the local community hospital that delivers the service. That might be a structural matter. Years ago I visited some of the community hospitals outside my constituency; they were so old that they were hardly suitable for the 20th century, let alone the 21st. A decision will have to be taken at local level about how and where the service is provided.
	The motion states that the Opposition are against the imposition of polyclinics
	"against local health needs and requirements".
	What is the evidence? There is little evidence. Most decision making in the national health service could hardly be called evidence-based. On the contrary, it is often a matter of wetting one's finger, putting it up in the air and seeing which way the wind is blowing. This is the first time I have said that, but it is a true representation of how decisions have been taken for the past 59 years.
	The hon. Member for Peterborough (Mr. Jackson) mentioned Kaiser Permanente in California. Studies in the US have shown that where there are more primary care practitioners on the ground—not just GPs, but other health professionals as well—there are healthier communities. That may be an international finding and it may not be specific to east Yorkshire or south Yorkshire, but in general, it is likely that by expanding the number of primary care health professionals, not just GPs, better health care will result for the people in that area.
	The Opposition motion opposing the imposition of polyclinics
	"against local health needs and requirements"
	echoes the BMA brief, which states:
	"The BMA acknowledges that there may be a case for establishing a polyclinic in some very specific circumstances, such as where local patients and clinicians agree on a proven need in their area."
	That has been the subject of debate for 59 years in the national health service. Who takes that decision? How is the need measured?
	I represent an area with very high disease burdens. Fifteen years ago it had the highest patient to GP ratio in England and Wales. It is a little less now because of the action that this Government have taken, but are GPs flooding into south Yorkshire to come and work alongside the hard-working GPs dealing with massive problems at every surgery, because of the difficulties that we have, sadly, with smoking, drinking, eating and the scars that industry has left on individuals? If it were not for the Government changing the GP contract, we would have the same patient to GP ratio that we had previously.
	I should like to know—I say this to those on both Front Benches and to everyone in the debate—how we measure the needs of communities, if not by looking at the disease burden that they carry and taking the action proposed by the Government to put GP services into those communities? What other way of measuring need is there? I do not know another way. If it is true that in America more primary health care professionals lead to healthier communities, the Government's proposals should be endorsed by everybody, including the medical profession.
	Most of the Government's proposals in recent months relating to family doctor services have been grudgingly accepted. One doctor turned up at my constituency surgery to discuss the issue of doctors' hours, which went to ballot. The rest of them get on with doing a very hard job under difficult circumstances because of the size of their patient list and the disease burden that those patients carry. The BMA badly misrepresents GPs, as it did on the issue of extending practice opening by a few hours in the evening and on Saturday. The BMA and the GPs within it are badly led.
	One of my constituents sent me a leaflet picked up in a neighbouring constituency. Headed "Your family doctor service is under threat", it states:
	"If we don't agree to this, the government has threatened to take this money away from patient services anyway and give it to local Primary Care Trusts (PCT) to fund large town centre 'Superclinics', probably run by private companies for profit. This could be the first stage in privatising all family doctor services and then the whole NHS."
	We heard the hon. Member for Wyre Forest say that family doctor services are not and never have been run by the state. They are private businesses that are run under contract to the state.
	The hon. Member for Peterborough said that the Labour party always harks back to what happened 60 years ago when the national health service was created. It was on precisely the matter of GPs that Nye Bevan fell out with many people, and I suspect with those on the Labour Benches in the Chamber, although at the time the Chamber had been knocked down for a few years. It was agreed that GPs would not work for the state, although there are some in my constituency and in all other constituencies who work on a salary, and thank goodness they do. That has enabled us to bring down the patient to GP ratio a little.
	I have had only two letters on the matter, but leaflets such as the one that I quoted are outrageous and do the profession terrible harm. A similar one was being circulated in neighbouring Doncaster. I am pleased that my right hon. Friend the Secretary of State stuck to his guns and said that, under the new contract and its treatment of doctors, it is reasonable for us to expect that doctors' surgeries should open on a Saturday morning. They always used to do so when I worked in industry, before I came to the House, and sometimes in the evening, to make it easier for people to attend.
	I am dismayed at the lack of professional leadership that the BMA provides to general practitioners. Dr. Laurence Buckman wrote an article on family service access. I have met him a couple of times and he is obviously an independent-minded person. In the  "Royal College of GP News" in February 2008, he is quoted as saying:
	"If there is a boat I'll rock it...I don't shy away from confrontation—people need to hear our point of view. I first got involved with the BMA because I was an angry young man with something to say and I still feel the same way now."
	The last trade union leader to say that was Arthur Scargill, and look what happened to the coal mines. I do not think that the GP surgeries in Rother Valley will suffer the same fate as the coal mines, but that is not good, sensible and responsible leadership. Dr. Buckman went on to say:
	"Politicians aren't primarily interested in the health service; they're out for what will be good for themselves and their constituents."
	That is absolutely right. After 59 years of being dictated to by those who work in the health service as opposed to those who need to use it, I could not agree more. If that man were representing me, I would be going along to the next branch meeting.

Sandra Gidley: Is this the same gentleman who has one of the highest rates of exempted patients in the country when it comes to calculating QOF points? He has the nerve to say that we are in it for what suits us, but he may be in it for what suits him.

Kevin Barron: I do not know the detail of his QOF points, but the Select Committee will be looking at QOF points later in the year in relation to health inequality. I expect that the debate will be ongoing for a long time, but I come back to how we can assess local health needs other than by measuring the disease burden in communities to determine whether we need more health practitioners, perhaps for preventive reasons or to enable people to be seen more quickly. How do we measure such needs other than by taking such action? Rather than destabilising or closing local GP surgeries, it will give them the opportunity to bid for and to work in the new centre in Rotherham.
	The Government seek to take the health service to those who need it so that they can make better use of it than they can at the moment because there are fewer doctors in their areas than there should be and those who are there are working hard with a difficult patient work load. The sooner this is sorted out collectively—it does not look as though we will reach a decision on the matter today—the better it will be for the NHS and our constituents.

DEFERRED DIVISION

Madam Deputy Speaker: I have now to announce the result of the Division deferred on the question relating to immigration. The Ayes were 265, the Noes were 65, so the question was agreed to.
	 [The Division Lists are published at the end of today's debates.]

Family Doctor Services

Question again proposed.

Peter Bone: It is a great pleasure to follow the right hon. Member for Rother Valley (Mr. Barron), who is always worth listening to. He is the Chairman of my Select Committee, so I must be nice to him.
	This has been an interesting debate. I come to it from the Northamptonshire perspective, but there are variations around the country, which worries me when it comes to the top-down approach of saying that every area must have a health centre or a polyclinic.
	I asked my staff to trawl through all our letters to see how many people wanted a centre that was open 12 hours a day, seven days a week, but I have not had a single request for that by telephone or e-mail or at my advice surgery. However, I have had a number of letters from constituents stating their concerns about polyclinics. My staff summarise it as follows:
	"Worried about loss of patient-doctor relationship. Seems to be older generation that are particularly concerned—value relationship with doctor, see same one frequently and they trust and are at ease with the same doctor."
	Those are the views coming from my patch.
	I have had a number of briefings from doctors on this subject. I went to a town hall-style meeting in the village of Great Doddington that was attended by 100 people, where the local GP spoke with great passion about her worry that the result would be that the village surgery would close. I can see the appeal of having many services on one site, but there is a real concern that centralising provision and making facilities bigger may result in the loss of village practices, which would be to the detriment of my constituents.
	I tried to intervene earlier on the Secretary of State. I think that he said that no practices would close as a result of this initiative.  The Guardian said that there would be a substantial loss of surgeries if the policy was to proceed, so when the Minister replies will he say whether I understood the Secretary of State correctly? That is an important issue.
	My second detailed explanation from a GP occurred last Tuesday, and I should explain the circumstances. Last Monday during the recess I did what every good Conservative should do and went out campaigning for Boris for the election, and I got a very good reception on the doorstep. Unfortunately when I had finished that electioneering I fell flat on my face, did my leg in and cracked my ribs and I was covered in blood. I finished up at the GP's surgery, and while she prodded and poked me she had a great opportunity to explain her concerns in some detail. In all the time that I have been a Member of Parliament, when I have been told something by those who are highly respected in the community, I have always taken on board their concerns. In that regard, I have a slight worry about the hon. Member for Dartford (Dr. Stoate). He must have a split personality. Being an MP he is not trusted by anyone, but being a GP he is trusted by everyone.
	In Northamptonshire, we have already arranged GP out-of-hours availability at two sites. The one that most of my constituents go to is Keydoc, so there is no problem about seeing a GP out of hours, although one could not see one's own GP. No one seems to want to see a change in that system.

Sandra Gidley: The hon. Gentleman raises an interesting point, because precisely that situation has arisen in many areas other than in Northamptonshire. It works well and there is a service there if people want it. I have been surprised by the number of GPs locally who have written to me saying that they can make a provision, but they object to being told exactly what to do, for how many hours and in what format.

Peter Bone: That is exactly the feeling in my area. Despite the fact that we have one of the worst ratios of GPs to population in the country, we have made rather a good fist of our arrangements, and our GPs are highly regarded.
	My constituents' real fear seems to be the loss of the relationship with the family doctor. Hon. Members say that that will not happen, which is good news if that is so, but I want to give a very real example that affected my family. My wife went to see her local GP, but saw another instead who said she had nothing to worry about. She did not get better, so she saw her own doctor, who knew her history intimately. She had liver cancer; she was immediately referred to the acute hospital and, thanks to the NHS, she was saved. This happened five years ago. My concern is if that situation had involved a polyclinic where she did not know the doctor, I am not sure whether she would have bothered to go back to get a second opinion.

Howard Stoate: I am interested to hear the hon. Gentleman's examples and am sorry to hear about his cut leg and cracked ribs. If the hon. Gentleman's GP had decided that he needed an X-ray, or if his wife's GP had decided to order a liver ultrasound scan, it would have been far better to have that X-ray or ultrasound scan then and there in the same clinic, rather than waiting for two or three weeks for provision in one of the local hospitals, which might be 20 miles away. Surely it is better to have the ultrasound scanner and the X-ray machine on the same site to deal with such matters as one-stop events?

Peter Bone: I am grateful to the hon. Gentleman for his intervention, because it takes me to my final point. Everybody in my constituency wants a hospital in the Wellingborough and Rushden area. I have found no one who does not want this. We must travel miles to get to a hospital, and we are in an expansion area where 52,000 new homes are about to be built. We want a hospital. Listening to this debate, my fear is that somebody will say, "They can have a polyclinic, because then we will not have to provide them with a hospital," which would be totally and utterly unacceptable. There are significant variations around the country, so I do not believe in one centrally imposed system. There may be great merit to those health centres, but they should not be centrally imposed everywhere.

Mark Simmonds: At times, the debate has been stimulating, and it has been interesting and necessary throughout. Many well-informed contributions highlighted the concerns in many different parts of the country. The key issues to come out of the debate are the disparity in existing provision, the nervousness about future provision and the potential for a break in the important GP-patient relationship. Any decision to improve provision and services should be taken locally and should not be imposed centrally.
	My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) opened the debate. He provided a thorough analysis and a detailed, comprehensive and authoritative explanation and understanding of the issues. He was right to highlight his support for family doctors, the importance of GP contracts, the need for GPs to remain as independent contractors and the tensions between primary and secondary care. He was also right to highlight the concerns about the imposition of polyclinics or GP-led health centres—it is whatever the Government have chosen to call them today—which will be centralised, top-down structures that will be unresponsive to local needs in some circumstances and undermine access in rural areas. The issue is about centralising primary care. The Opposition do not oppose polyclinics or GP-led centres, when local needs desire and require them.
	The Secretary of State for Health is a disarming man with a charming and calming manner, which is why, I suspect, he has been put in that job.

Graham Stuart: Where is he?

Mark Simmonds: Sadly, the Secretary of State is not in his place. Unusually for him, the issue has clearly rattled him. He did not set out how he will explain to his constituents that the PCT that covers his constituency has admitted that it sees the imposition of a polyclinic as an opportunity to reconfigure GP services, thereby possibly closing existing practitioners. He did not support the family GP, and, interestingly enough, he did not defend the imposition of health care centres or polyclinics.
	In response to my intervention—it will be interesting to see whether he confirms this later—he stated that primary care trusts do not have to have a polyclinic or a GP-led health centre and can therefore use the resources that would have been allocated for other, locally driven services. We will wait and see whether he substantiates that point outside this House.
	The hon. Member for North Norfolk (Norman Lamb) once again explained how his party plans to politicise PCTs' expenditure decisions by direct, local political interference. He rightly highlighted low morale among GPs and the need to review the quality assessment framework. He was also right to highlight the importance of preventive health care and the link to health inequalities. We need greater emphasis on public health. The PCTs with the greatest level of deprivation often spend the least resources on public health.
	My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries) expressed her genuine concerns on behalf of GPs in Bedfordshire and about the imposition of GP-led health care centres in her constituency based on the potential breakdown of the GP-patient relationship. She rightly highlighted the importance of decisions being made locally in Bedfordshire in response to local community needs and questioned the logic behind the imposition of such schemes against local wishes. It will be interesting to hear what the Minister says in response to her points.
	The hon. Member for Wyre Forest (Dr. Taylor) is a distinguished and knowledgeable Member of this House who always makes an interesting contribution to health debates, and today was no exception. He was correct to highlight the fact that GPs are independent contractors, but it must be right to harness the independent sector to drive improvements in the provision of health care, which should always take place through the prism of patients rather than through the prism of the delivery mechanism. It is right that the Opposition support any willing provider. I can give the hon. Gentleman the assurance that he seeks: the Opposition passionately believe that the NHS should be free at the point of delivery, and we are completely committed to the objectives and ethos of the NHS.
	As the House knows, the hon. Member for Dartford (Dr. Stoate) is a practising general practitioner, and he is extremely knowledgeable about these matters. However, I wish he would use that expertise and knowledge constructively rather than unconditionally supporting Health Ministers in whatever they are trying to do, regardless of whether those things are in patients' interests. He is right to highlight the additional pressure on accident and emergency departments, which was initially a direct result of the Government contracting both extended and out-of-hours services under the GP contract, which came into operation in 2004. Before I move on, I also want to know whether the hon. Member for Dartford is one of the 3 per cent. of GPs who are happy with the Government's handling of the NHS, or whether he is part of the 97 per cent.
	The right hon. Member for Rother Valley (Mr. Barron) is a distinguished Chairman of the Health Committee, and his contributions are always thoughtful and serious. He was right to say that GPs are the backbone of the NHS and that less well-represented areas often face serious problems with health inequalities. There is no political difference between the three main political parties that that needs to be addressed. However, the Government amendment deliberately obfuscates and confuses two particular central Government initiatives, which need to be separated and debated independently. As the right hon. Gentleman said, patients demand greater access, and we support that demand where it is necessary. However, we also need to consider why it is there. The reason Members of Parliament found significant constituency concern when the contract was changed was that patients found that access to their GPs was not as it had been before. That concern has died down because patients have found a way of circumventing the problem, by going to accident and emergency and putting additional pressure on ambulance trusts. We need to make sure that the decision in respect of services used is with the patient, not with central Government.
	We then heard from my hon. Friend the Member for Wellingborough (Mr. Bone), who made a significant contribution based on experience in Northamptonshire. He was absolutely right to highlight the possible loss of the relationship between GPs and their patients.
	I missed out my hon. Friend the Member for Peterborough (Mr. Jackson), but I should not have done—he is an assiduous and tireless defender of his constituency's interests. He was right to highlight the Government's failure to deliver improvements, particularly in the context of the significant amount of taxpayers' money that has been invested in the national health service. He was also right to point out the important requirement for GPs and their patients to be consulted properly about the central Government proposals.
	My hon. Friend was right, again, to point out the benefits of consultation when Governments listen to what local people want. He gave a direct example of how that had benefited his constituents in Peterborough. My hon. Friend was correct to put on the record the significant inward economic migration, which has affected his constituency and mine and put great stress on public sector services in Peterborough and Boston.
	In the time that remains, I want to highlight some of the key issues. I turn first to the GP contract. We should not allow the Government to get away with the view that GPs are somehow responsible for the reduction in out-of-hours and extended hours provision. That reduction was the direct result of the GP contract that was imposed by the Government and effectively led to reduced patient access. Furthermore, the cost of out-of-hours provision has increased by two or three times because the Government have insisted that it should be provided by primary care trusts rather than general practitioners. That has led to announcements, even last week, of cuts in out-of-hours services by contractors to primary care trusts.
	The subsequent Government reversal, as they attempted to reinstate what they were responsible for withdrawing, has shattered the relationship between the Government and GPs, resulting in GPs being very upset. In a poll, 98 per cent. of them said that they thought that the Government's methods of negotiation were unacceptable and 97 per cent. said that they had no confidence in the Government's handling of the national health service.
	All that is not the responsibility of the current Secretary of State. However, he has exacerbated the problems through his Department's tactics. The Government seriously miscalculated the number of points that GPs would earn. They rewarded GPs for a level of activity that was already in place, and that has been a significant contributory factor in the drop in productivity, leading to an additional cost of £1.76 billion to the taxpayer.
	We Conservatives are not against polyclinics or GP health centres; in fact, when they are supported by the local community, via GPs and patients, we support them. However, we are deeply concerned about the Government's plans to impose polyclinics or GP health centres in every primary care trust. That is imposition without consultation or evidence. According to the Department of Health website, the consultation process is supposed to finish on 15 May, three weeks' time. However, in certain circumstances there has, to date, been no consultation at all.
	The House must understand that we are not talking about some minor tweak to primary care. The establishment of GP-led health centres and polyclinics will be the largest change to primary care since the establishment of the NHS 60 years ago. We have heard stories about how polyclinics and GP-led health centres will be inconvenient for some individuals. They will be suitable for some, particularly in urban areas, but there is real concern among GPs—and, more importantly, their patients—in rural communities.
	The framework for action, which was specifically about London, set out that polyclinics will be cheaper and more convenient. There are arguments against the contention that they will be more convenient, particularly in respect of rural areas. In fact, polyclinics are more expensive than traditional GP surgeries, in respect of not only infrastructure, but the occupancy costs per patient. In addition, the Government must not underestimate the importance of GPs acting as gatekeepers controlling access to expensive secondary care. We Conservatives will not coerce GPs and their patients into polyclinics against their will.
	Other mechanisms and structures could be put in place and need to be considered. For example, an innovative system is operating in the floor above the Boots store in the centre of Poole, where a consortium of GPs is providing a range of services that are proving much more accessible than those at the traditional GP practice.
	Let me ask a few brief questions. Ministers are not—or were not until the Secretary of State seemed to change the policy earlier—allowing PCTs to consider the appropriateness of a polyclinic or GP-led health centre for their area. Will the Minister confirm his view? Ministers are not insisting on consultation, ensuring consideration of the impact on patient care or basing their decisions on evidence. Ministers are not allowing PCTs to use their money instead to improve the provision of health care through existing practices. Why, for example, will they not allow PCTs to use this money to invest in community hospitals rather than GP-led health centres—the point made by my hon. Friend the Member for Beverley and Holderness (Mr. Stuart)? Why will not they allow non-spearhead PCTs to invest this money for smaller GP practices in socio-economically deprived areas, thereby reducing health inequalities? Why will they not allow this money, if desired by a primary care trust, to be invested in, for example, occupational health?
	In short, the Government have been holed below the waterline as regards any suggestion that the central command and control era is over—in fact, it is going in exactly the opposite direction under this Prime Minister. At a time when the Government are closing and downgrading rural services such as post offices, local schools and police stations, we cannot have yet another local service under threat. Local accountability, local decision making, local consultation and local needs and requirements are all being overridden by Ministers. We will change that. We will empower local GPs and patients to reflect local communities' needs and requirements, driven by quality of service and by patient outcomes. Our plans will drive improvement in the provision of health care and deliver a better, more effective, more efficient and patient-focused national health service.

Ben Bradshaw: We have had a good debate, and I will try in the time that is left to respond to some of the specific points that hon. Members have made.
	Before I do so, I should like to reaffirm the importance that we place on family doctors. The relationship between a patient and their local GP is one of the most important features of the NHS. As Nye Bevan said,
	"The family doctor is in many ways the most important person in the Service."
	We recognise the vital importance of the GP as provider and commissioner of care and as a strong advocate for their patients' health and well-being. The primary care system in this country is the envy of the world. I therefore reject the accusation contained in the Opposition's motion that GPs are undervalued and under-appreciated. In fact, there are today more than 5,000 more GPs than there were in 1997, and their average pay has increased from £46,000 in 1997 to £110,000 in 2005-06. Investment in primary care services has more than doubled from £3 billion in 1997 to £8 billion in 2005-06, and GPs as a whole do a fantastic job.
	However, health care can never stand still. Sixty years on, the NHS must react to 21st century challenges, offering services that are responsive to what patients want and need. The NHS next stage review interim report, "Our NHS, our future", which we published last autumn, recognised the need to improve access to primary care and community services, and it set out a number of proposals to make services more equitable and to ensure that patients have real choice. Those included £250 million of new money for new GP practices in the most under-doctored areas, benefiting patients in 50 primary care trust areas, and for more than 150 new GP-run health centres—one in each primary care trust area in England.

Rob Marris: Will my hon. Friend give way?

Ben Bradshaw: I will not, because I have only a few minutes to respond. The Opposition Front-Bench spokesman took rather longer than I was expecting.
	Those health centres will allow any member of the public to pre-book or simply to walk in and be seen by a GP from 8 am to 8 pm every day of the week. They will all have a strong focus on promoting health, particularly to hard-to-reach groups, and on preventing health inequalities. When we talk about developing health centres or when some local parts of the health service describe plans for polyclinics, we are not referring to a single, fixed model of care. These terms describe flexible models for bringing primary care together with a range of other services, be they diagnostic services, specialist care for patients with long-term conditions such as diabetes, or social care. Research shows that the public want services that are more joined up, and it shows that more integrated care produces better health outcomes. But there is no one-size-fits-all solution. What matters is doctors, nurses and other clinicians working with the public to design integrated care to meet local circumstances. That is why the Government are providing investment for the new health centres, and why we have given the local NHS the flexibility to design the services that will be based in those centres.
	Although we are not prescribing specifications for the new services—it will be up to SHAs and PCTs to design those with local communities—we are saying that there needs to be a small number of core requirements, which are expected by the public. For GP practices in under-doctored areas, those requirements include extended opening hours, engagement in practice-based commissioning and wide practice boundaries to secure the maximum level of access. For the health centres in every primary care trust area, those include: an easily accessible location; being open from 8 in the morning until 8 in the evening, seven days a week; bookable GP appointments and walk-in services; services for registered and non-registered patients; and a maximisation of the opportunities to integrate and co-locate with other community-based services.
	To respond to the question put by the hon. Member for Wyre Forest (Dr. Taylor) about the role of the independent sector, even if every one of the new health centres and all of the extra capacity that we are creating in the NHS at primary care level were won by the independent sector—and that is not what is happening—the proportion of provision of primary care run by the independent sector would amount to only 3 per cent. of the national total. I would add that existing GPs are private contractors.
	It was suggested by a number of Conservative Members that the public were not interested in more flexible opening hours for GPs. They claimed that there was no demand for them. I have to tell them that every single poll—not just those done by the Department, but those carried out recently by MORI and by Which—shows that it is a priority for the public. When record investment is going into GP services, they do not consider it unreasonable to be able to visit a GP at a time that is more convenient for them.
	The proposals are also popular in rural areas. Dr. Michael Dixon, the chairman of the NHS Alliance, will be well known to many in this House, and he said recently:
	"I know that many GPs and others have difficulty with the word 'polyclinic'...but the concept of bringing practices together and providing a greater range of integrated services in the community has to be right...It might be true that small is beautiful, but professional isolation and poorly integrated services are not...Practices need increasingly to work with each other and with other partners in primary care, whether as virtual partners or on one site".
	Dr. Dixon, whom I visited with the Secretary of State last week, practises not in inner London or inner Manchester but in rural Devon. His fantastic health centre in Cullompton, far from making it harder for local people to access services, means that many people in the surrounding villages and Cullompton no longer have to travel to Tiverton or further afield to Exeter for treatment. Instead, they can receive them on their doorstep, in their local market town. Moreover, his surgery is about to embrace evening and Saturday morning opening.
	When one looks at the London model, one finds that 29 out of the 31 primary care trusts in London are already working on proposals—bottom-up, not top-down—for health centres in their areas. A recent survey by the British Medical Association, no less, found that 70 per cent. of GPs in London said that their premises were "inadequate".

Andrew Lansley: Will the Minister give way?

Ben Bradshaw: No I will not give way, I am afraid.
	The hon. Member for Peterborough (Mr. Jackson) suggests that extended opening will be used only by yuppies in four-wheel drive cars who are about to fly off on holiday. I have to say that where we have had extended opening, whether it is in Barking and Dagenham or Tower Hamlets, the patients accessing services in the evenings and Saturday mornings are not four-wheel-car-driving yuppies, but blue-collar workers, who otherwise have to take time off work and lose money from their pay packets.

Andrew Lansley: rose—

Ben Bradshaw: Some are families with young children, and some of them are pensioners, and they appreciate the extended hours delivered by this Labour Government. [Hon. Members: "Give way!"] It is not just in Devon or in London—

Hon. Members: Give way!

Madam Deputy Speaker: Order. It is obvious that the Minister is not giving way. He must be heard.

Ben Bradshaw: The services are proving popular not only in London and Devon. In South Cambridgeshire, the constituents of the hon. Member for South Cambridgeshire (Mr. Lansley) will get a new GP-led health centre in St. Neots. The Sawston medical centre already offers integrated services, including minor operations and audiology as well as general practice. In Eddisbury, the constituency of my opposite number, the Dene Drive primary care centre has three GP practices, which offer integrated services under one roof.  [Interruption.] From a sedentary position, the hon. Member for Eddisbury (Mr. O'Brien) admits to opening it in February.
	Sheringham, in the constituency of the hon. Member for North Norfolk (Norman Lamb), houses eight GPs, with expanded services, and it recently benefited from a £1.2 million extension under the Government's LIFT programme. In response to a question from the hon. Gentleman, it is not true that the money was conditional on its being spent on extended opening, as he alleged.
	As part of our current negotiations with the BMA about the new contract arrangements, we have agreed to invest up to £105 million in new GP services. That will include money to fund the pay recommendations. We reached broad agreement with the BMA on the new services, but I am afraid that I cannot announce them to the House today because the BMA is still challenging the pay recommendations. However, I share the hope of the hon. Member for North Norfolk that we can make a positive announcement along the lines that he said he would like.
	The hon. Gentleman is right about the minimum practice income guarantee. As my right hon. Friend the Secretary of State made clear in his opening remarks, we will tackle that when Lord Darzi publishes his final report in the summer. I have asked Westminster primary care trust for an explanation of the arrangements that the hon. Gentleman described at Buckingham palace and Westminster school, but he will accept that they may result from the minimum income guarantee rather than anything less acceptable.
	The hon. Gentleman knows that we have been involved in an intensive six-month period of work on practice-based commissioning to encourage better commissioning. The primary care trusts are now responsible for ensuring that practices are properly supported, and we will hold them to account to ensure that they give practices the necessary support to realise practice-based commissioning, to which we remain committed.
	The motion must be one of the most extraordinary motions on health tabled by the Conservative party. It follows an astonishing speech by the Leader of the Opposition on Monday, which advocated giving GPs a veto over more convenient opening times, and a Conservative-supported GP petition, which states:
	"We...believe that we should be free to determine the opening hours, size and locations of our practices".
	The Confederation of British Industry described the Leader of the Opposition's speech as perplexing. It stated:
	"Mr. Cameron's speech contains disappointing echoes of the arguments of those who have long opposed any reform of the...public sector".
	The speech and the motion could have been written at BMA headquarters.
	The motion is accompanied by an equally ludicrous press release from Conservative central office, with the headline, "Labour's secret blueprint for polyclinics". The Tories claim to have uncovered guidance that amounted to a threat to family doctors' services throughout the country. The only problem is that my fellow Health Minister, Lord Darzi, announced the guidance in a speech at a national conference in December and it has been publicly available on the Department's website ever since.
	Far from being a threat to family doctors' services, our plans will provide 265 new GP practices and GP-led health services throughout the country, on top of the existing 8,500 GP practices, with £250 million of new money. A new health centre that is open from 8 am until 8 pm, seven days a week, will be set up in every PCT area, and 103 new GP practices will be established in 50 of the least well-served areas of the country.
	The public say that the ability to see a GP at a time that is more convenient to them is the one further improvement that they would like in the health service. With record investment going into GP surgeries, we on the Government Benches do not believe it unreasonable of the public to expect that improvement, and that is what our proposals will deliver.
	It is extraordinary, although not surprising, that the Conservative party is aligning itself so firmly with the forces of conservatism against improving health services for the public. That might curry it some favour with the BMA, but most people can spot producer interest capture when they see it. What an astonishing—and from our point of view welcome—set of affairs that the Conservatives should be positioning themselves so firmly on the wrong side of the health argument. That is why their motion will be defeated. I commend our amendment to the House.

Question put, That the original words stand part of the Question:—
	 The House divided: Ayes 211, Noes 306.

Question accordingly negatived.
	 Question, That the proposed words be there added,  put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
	Madam Deputy Speaker  forthwith declared the main Question, as amended, to be agreed to.
	 Resolved,
	That this House welcomes the fact that the Government is providing £250 million, in addition to existing GP services, for 152 new state-of-the-art GP-led health centres open from 8 a.m. to 8 p.m., seven days a week; notes that these will offer a wide range of health services including prebookable GP appointments and walk-in services; further notes that where patients previously had trouble seeing their GP or had to make numerous visits to a variety of health professionals, they will now be able to see a doctor more quickly, collect their prescriptions, get their eyes tested, have a variety of diagnostic tests or see a physiotherapist in the same building and at times convenient to the patient; further welcomes the additional centrally funded 100 GP practices to be located in the most deprived areas which will have a strong focus on promoting health and reducing inequalities; acknowledges the landmark agreement with GPs to extend surgery hours in evenings and on Saturdays and agrees that extended access will benefit hardworking families; further welcomes the extension of the role of pharmacies to be able to prescribe for and deal with minor ailments on the NHS, as well as promoting good health, supporting those with long-term conditions and preventing illnesses through additional screening and advice; recognises that the Government is on the side of patients; and agrees that extending access to GP services through extended hours and new GP health centres can have a real impact on health inequalities.

Crime (London)

Madam Deputy Speaker: I have to announce that Mr. Speaker has selected the amendment in the name of the Prime Minister.

David Ruffley: I beg to move,
	That this House supports the dedication of police officers in the City of London Police, the Metropolitan Police Service and the British Transport Police but notes the unacceptable trend in teenage murders in London, including the shocking figure of 27 murdered in 2007; believes that Londoners' daily experience of crime, particularly lower level crime and anti-social behaviour, is now far removed from some official statistics; is deeply concerned that violent crime in London as measured by the British Crime Survey is the highest of all the regions in England and Wales and that fear of crime in London is now also the highest of all the regions in England and Wales; further notes the link between gun crime and drugs; further believes that local communities should be given greater freedom to direct the efforts of their police force if streets are to be made safer; and condemns the current Mayor of London for his complacent attitude to these serious crime issues.
	London is the greatest city on earth. It is protected by the dedicated officers of the Metropolitan Police Service, the City of London police and the British Transport police, whom I have had the privilege of visiting during most of today. But it is also the city where the British Home Secretary, on her own admission, does not feel safe walking alone at night, and it is the city where 27 teenagers were murdered by other teenagers in 2007. Last month, a Labour Back Bencher, the hon. Member for Islington, South and Finsbury (Emily Thornberry), said "I suspect that hardly any children in Islington have not been mugged at some stage."
	London is the city where more teenagers are being mugged each year. The Metropolitan Police Service figures—not the Home Office departmental figures—show that the number of 11-to-22-year-olds reported to have been mugged in London rose from 19,276 in 2004-05 to 24,701 in 2006-07, an increase of 28 per cent. In Lewisham alone, 454 more muggings were recorded over the same period, an increase of 88.5 per cent. The Minister should note that those are Metropolitan Police Service figures.
	According to the British crime survey, London has the highest level of violent crime among all the regions in England and Wales, and also the highest level of fear of crime. Londoners are twice as likely to be robbed as people in New York city. Violent crime has increased over eight years, according to official measurements of total violent crime and to measurements of violence against the person. The respective increases have been 15.3 per cent. and over 15 per cent. Those are the Mayor's own figures. Robbery has increased by just under 20 per cent. in eight years. In 2007-08 there were more than 37,000 incidents of robbery in London. Those too are the Mayor's own figures. The number of sexual offences was greater in 2007 than in 1999 to 2000, according to Metropolitan Police Service figures.

Andrew Love: The hon. Gentleman has quoted Metropolitan Police Service figures. Does he accept that violent crime has fallen by 8 per cent. in the last year, also according to Metropolitan Police Service figures?

David Ruffley: No, I do not, because of the statistics that I have just read out. The hon. Gentleman really ought to spend a bit more time listening and a bit less time mouthing off. If he reads  Hansard tomorrow, he will see why he is wrong. Those statistics show beyond peradventure that violent crime is on the up in the capital.

John Randall: I am sure that my hon. Friend has not had time yet to read today's  Uxbridge Gazette, but when he does, he will find out that Hillingdon has London's third highest daily crime rate, and in the last year there were 6,925 violent crimes—or 19 a day—in that borough alone. Does he think that that is acceptable?

David Ruffley: No, I do not. That is a reproach to the hon. Member for Edmonton (Mr. Love) who, when we debated the issue of crime in London last month, came up with the same selective nonsense as he did a few moments ago.

David Burrowes: Following the intervention by my neighbour, my hon. Friend the Member for Uxbridge (Mr. Randall), we cannot be complacent about violent crime, given that there have been five murders in Edmonton since Christmas and that London has the highest levels of fear of crime—according to Government figures.

David Ruffley: I entirely agree with my hon. Friend, and Labour Members should stop being so complacent. We can celebrate the dedication and hard work of London police officers, but let us not pretend that there is not a problem with crime.

Daniel Kawczynski: My hon. Friend mentions police officers. Will he join me in thanking the police officers who protect us here in the House of Commons? They do a tremendous job. Does he also agree that more needs to be done to ensure that everyone respects police officers more?

David Ruffley: I agree, and statistics show that offences against and assaults on police officers have risen in the past 10 years. That is a cause for concern and something must be done. That emphasises our point that there is more violence about, and whether it is against civilians or police officers, it is utterly unacceptable in London. Labour Members are way too complacent about that.

David Evennett: My hon. Friend is making a powerful and effective case—[Hon. Members: "No, he's not."] Labour Members do not like to hear the truth. My hon. Friend has highlighted the real problem. In my area of south-east London, there is a real and growing fear of crime. People know that violent crime is increasing and they want a new approach.

David Ruffley: They want a new approach and they also want the Government to accept that, according to the British crime survey, fear of crime is higher in London than in any other region in England and Wales. That is a fact.
	The statistics illustrate why Londoners rightly believe that they need and deserve tougher, more effective law and order policies. We have set out such policies in the past few weeks. But we can only satisfy that demand by Londoners if we give the police the tools to do the job. We believe that a London Mayor must chair the Metropolitan Police Authority for the first time, and I hope that my hon. Friend the Member for Henley (Mr. Johnson) will do that in very short order. As a top priority, he will use his influence to cut red tape on our police men and women, so that they can get out on the streets and do the job that they so badly wish to do.
	Secondly, the public spaces of buses, trains and railway stations must be made safer, with more visible police and new sanctions for offenders, especially those guilty of antisocial behaviour—something that my hon. Friend has spoken about powerfully and in detail in past weeks. We support him in that.
	Thirdly, the levels of knife and gun crime in this city are unacceptable and must and, I trust, will be tackled by more weapons scanners—we can show how we would pay for those—and the reform of stop-and-search powers.

Mike Gapes: I am grateful to the hon. Member for Bury St. Edmunds (Mr. Ruffley)—not a London constituency. Did he—like the hon. Member for Henley (Mr. Johnson), another non-London constituency—vote against introducing an automatic five-year sentence for possession of an illegal gun? Or is he, like the hon. Member for Henley, all words and no action?

David Ruffley: That is a tired canard and it is not worth replying to it. We have gone round the track on that many times and the hon. Gentleman knows that it is a non-point. Londoners who are listening will not believe for a second that my party—the party of law and order—is soft compared with his lot, not just in the past 10 years but in the past 50 years.

Andrew Dismore: Perhaps I can try the hon. Gentleman on this point. Does he agree with the hon. Member for Henley (Mr. Johnson), who opposes what he calls
	"the whole of the new anti-yobbo programme"—
	basically, all the measures to do with antisocial behaviour—or not?

David Ruffley: The hon. Gentleman will try anything on; if he wants to try that, he can forget it. Let us move on to some serious debate.
	Fourthly, we believe in reorganising the mayoral financial budget to deliver long-term funding for neglected rape crisis centres. Finally, we believe that the police service in London can be made more accountable to Londoners by giving local communities, for the first time in this country and in this city, online crime maps that show the true levels of crime in every neighbourhood, which can ensure that borough commanders are held better to account at monthly open public beat meetings.
	On the first of those issues, tougher law and order priorities have to be set by a new London Mayor. The Mayor has the right to do that under existing legislation by chairing the Metropolitan Police Authority, but he currently does not bother to do so. Is that because he does not take law and order seriously? That is what we think. We believe that a new Mayor could drive a new policing plan drawn up in consultation with the Metropolitan Police Commissioner that will, as a priority, slash form filling. It is unacceptable that officers in London spend more time on paperwork than they do on the beat—about one hour in five is spent on the beat compared with the time spent doing other things. That is not acceptable.
	Even the commissioner, Sir Ian Blair, has said that the police need "a bonfire of bureaucracy", yet Mr. Livingstone's current policing plan up to 2010 does not list that as any kind of priority.

Simon Hughes: As I am a London Member of Parliament, representing more than 100,000 Londoners, will the hon. Gentleman accept that although there are severe problems with which no politicians and police have yet dealt, such as gun crime and the deaths from such crime, he does this city no service by trading statistics that give a wrong impression in many respects and add to the fear of crime? Will he give a commitment that whoever wins the London mayoral election, whoever ends up on the Front Bench and whichever party is in government, his party will seek, along with the other two main parties, to agree the statistics? That would mean that this ridiculous debate, which goes on every year, could be put to bed and we could get on with discussing the issues rather than trading party political points across the Chamber.

David Ruffley: The hon. Gentleman has made half of a good point, in the sense that there is confusion and a bit of argy-bargy about statistics. However, he should have listened carefully to what I was quoting, because he would have realised that the British crime survey and the Metropolitan Police Service are pretty objective sources of data, which the Labour party chooses to ignore when it suits them.

Theresa Villiers: Does my hon. Friend agree with my constituents in Chipping Barnet that neither the Government nor the Mayor of London have taken any kind of effective action to tackle the growing problem of antisocial behaviour and crime on our bus network?

David Ruffley: My hon. Friend is entirely right. I shall come specifically to the point about the rising number of code red calls and the increasing antisocial behaviour figures, provided by the MPS, which she rightly mentions.

Clive Efford: Would the hon. Gentleman care to comment, in response to the hon. Member for Chipping Barnet (Mrs. Villiers), on Barnet council's website, which says that there has been a 17.5 per cent. reduction in crime between 2005 and 2008? That is a Conservative authority.

David Ruffley: The hon. Gentleman would do well to listen to the BCS London figures and the MPS figures that I have quoted.  [ Interruption. ]

Madam Deputy Speaker: Order. Can the debate be conducted in an orderly manner?

David Ruffley: Thank you, Madam Deputy Speaker. I think that it is now time to—

Several hon. Members: rose —

David Ruffley: We could trade statistics all day— [ Interruption. ]

Madam Deputy Speaker: Order. It is obvious that the hon. Gentleman who is on his feet is not prepared to give way at this moment in time.

David Ruffley: I am grateful, Madam Deputy Speaker.
	Solutions are surely what we should be talking about. They also represent a huge divide between the proposals of that lot on the Benches opposite and the constructive, well thought through and well funded proposals of the Conservative opposition in London and in the House of Commons.
	Sir Ian Blair is right to identify the amount of paperwork as a problem for the police. How can we make some kind of dent in it? The Metropolitan Police Authority has talked endlessly about cutting the number of forms that need to be filled in, but it has never got around to doing anything about it. It is nonsense to say that it is not the MPA's responsibility, but the Minister for Security, Counter-Terrorism, Crime and Policing could have done much more in that regard. Moreover, any go-getting and serious Mayor who cares about law and order could play a key role in getting police chiefs to cut the amount of paperwork that police have to complete. It can be done.
	The Government have been havering about one particular proposal that has been made, but we have stated clearly and unambiguously that we will abolish the stop-and-account form. No ifs, buts, maybes or promises of a review: we will cut it. In the Met area last year, 384,115 people were stopped, and the form involved is a foot long. Estimates vary, but it can take as long as 25 minutes to fill it in. On that basis, we believe that more than 160,000 police hours were taken up last year by the need to fill in a form that we will abolish when we come into power.

Dawn Butler: Does the hon. Gentleman agree that the Leader of the Opposition was being extremely disingenuous when he held out a stop-and-account form? He allowed the carbon copy to fall open, but the form itself is not a foot long. The police say that it takes about four minutes on average to fill one in. Does he also accept that it is not too much to ask of a policeman that he spends four minutes establishing a rapport with the person being stopped and searched?

David Ruffley: I direct the hon. Lady to the review by Sir Ronnie Flanagan that was published in the first week of February. I am sure that she has heard of it, but she should try to read it as well. In it, he talks in detail about the length of the form and how long it takes to fill it in. I agree with Sir Ronnie who, being a police officer and the chief of Her Majesty's inspectorate of constabulary, knows a bit more about these matters than anyone in this building. If she has a problem with the form, I suggest that she take it up with him.
	A Conservative Government will get rid of the stop-and-account form, but we also believe that the stop and search procedure needs serious reform. An officer who stops and searches a member of the public will still need to record what we acknowledge will always be an intrusive procedure. However, not enough has been done by the Met or Ministers to put in place a system whereby the essential details of a search are radioed in to a police log at a call centre, where they could be taped.
	Using that method, stop and searches would still be recorded, but in a paperless way. That would save time and bureaucracy and, under our proposal, a person unhappy about the circumstances of a search would still be entitled to visit a police station and request the information held about it. What could be easier than that? All that it requires is a bit of the political will so sadly lacking in the Labour party and in the London Mayor who, I believe, has held office for far too long.
	With their new laws, targets and forms, this Labour Government have presided over piles of paperwork, both locally and nationally. The Minister repeatedly claims that 9,000 forms have been cut nationally, yet—amazingly—he refuses to publish the list. If his officials have counted that many forms, he must surely have such a list in his possession. Will he publish it today? I bet that the answer is no.

Harry Cohen: Earlier in his speech, the hon. Gentleman slipped in the remark that, if the Conservatives won the election, they would redistribute parts of the crime budget. That would be their prerogative, but the current Mayor has offered London boroughs some £79 million to help in the provision of youth facilities. In many cases, the areas that would benefit are the ones with the most gun crime. Would the Conservatives cut that money, or redistribute it away from those areas?

David Ruffley: The hon. Gentleman asks a very long question, but it has a very simple answer: we will not cut that money.
	London needs proper leadership from a new Mayor who is dedicated to helping the police, but the second problem has to do with how we can make trains and buses safer. In 2007, Mr. Livingstone stated:
	"London's buses are a low-crime environment".
	I am afraid that the facts tell a radically different story. Tube crimes are on the increase, public disorder offences increased by 33 per cent. between 2005-06 and 2006-07, criminal damage was up by 36.9 per cent., and sex offences on the tube were up by 14.9 per cent. The source for that, if anyone really wants to trade statistics, is the British Transport police's statistical bulletin 2006-07. I was with members of the British Transport police this very lunchtime, and they confirmed those figures to me personally. If any Labour Member wants to intervene on me, I am happy for them to do so. No? Okay.
	Tube crime—up. Crime on the buses—up. The London assembly's transport committee found at the beginning of the year that overall crime on buses increased by just over 17 per cent. between 2004-05 and 2005-06. The source for that is the committee's report of January 2008.

Karen Buck: Will the hon. Gentleman give way?

David Ruffley: If it is to make an intervention on that point.

Karen Buck: I am grateful. If I heard him correctly, the hon. Gentleman was citing figures for 2004-05 and 2005-06. Actually, to give us a common baseline for the most recent year, the figures show an 11 per cent. fall in crime on London's buses. That selective use of statistics, which he accuses other people of, calls his entire argument into disrepute.

David Ruffley: Not in the least, because no one in this House, and I hope that the hon. Lady is not an exception, thinks that crime on the buses or on the tube— [Interruption.] Is it higher or lower than when the Mayor came into office? Right, okay. I think we have the answer to that.

Stephen Hammond: If we are going to trade statistics about the buses, I shall say that Transport for London's latest press report on numbers, which had a 2006 baseline, indicating the year 2007 numbers, mentioned a 3.4 per cent. increase.

David Ruffley: I am grateful to my hon. Friend.
	Assaults on the buses are up. TfL's internal papers confirm that the most recent period showed a 10 per cent. increase in the number of assaults on passengers, staff and members of the public compared with the same period last year. The source for that is the surface advisory panel's documents of 13 February 2008, page 49, for those who might be interested.
	Antisocial behaviour on the buses is also up. Under-18s travel free on the buses in London, which is a good thing, but we all know that a minority of under-18s abuse that cherished privilege. TfL's figures show that incidents of code red calls made by bus drivers in London due to antisocial behaviour increased from about 470 cases in August 2005 to 697 cases by the end of 2006. That is from the managing director's report.

Justine Greening: I am sure that my hon. Friend also recognises that many of the victims on buses are young. Often, they hope that adults on the bus will get involved, but adults these days do not want to. They feel completely on their own when they are confronted with such problems on buses.

David Ruffley: I agree entirely with my hon. Friend.

Boris Johnson: rose—

David Ruffley: I was going to come on to my hon. Friend's proposals to meet the concerns of my hon. Friend the Member for Putney (Justine Greening).

Boris Johnson: I agree deeply with my hon. Friend's profound analysis of what is going wrong on London transport. The 100 per cent. tolerance of so-called minor disorder and minor crime on the buses and the tubes is aggravating more serious criminality on the streets and leading to the real scandal that a person is twice as likely to be mugged on our streets in London today as in New York. That is because we have 100 per cent. tolerance of so-called minor crime.

David Ruffley: As ever, my hon. Friend gets it absolutely spot on. Like many on the Conservative Benches, he has learned the lesson that if one cracks down on so-called low-level crime in a zero-tolerance fashion, that inevitably leads to a cut in much more serious offences, as night follows day. That is what the empirical evidence around the world demonstrates. It is taking my hon. Friend to speak out and say that London needs a Mayor who believes in that policy. The current Mayor clearly and palpably does not.

Bob Neill: Are not my hon. Friend's last point and the point made by my hon. Friend the Member for Putney (Justine Greening) reinforced by the extraordinary development that, when a London headmaster wrote to the Mayor complaining of abuse of the free travel pass leading to attacks on the school pupils for whom he had responsibility, the Mayor's response was to have the arrogance and temerity to describe that decent headmaster as a Victor Meldrew? What sort of political lead is that from the Mayor of London?

David Ruffley: It is no kind of leadership and my hon. Friend's point, like that of my hon. Friend the Member for Putney, speaks to arrogance and complacency about antisocial behaviour in public spaces, especially in London transport settings.
	From the start of the travel pass scheme in September 2005 until July 2007, only 394 bus passes were permanently withdrawn from under-18s despite the fact that there is clearly a problem, as has been demonstrated both in Putney and in Bromley. The TfL behaviour code defines antisocial behaviour in ways we would all recognise—using offensive or threatening language, smoking, playing music very loudly, damaging or defacing photo cards, physical or verbal abuse, unlawfully carrying a weapon and drug use. TfL figures show the staggering statistic that 65 per cent. of Londoners have experienced or witnessed antisocial behaviour on buses or tubes in the past two years—two out of three Londoners. That is a fatally depressing statistic of which Mr. Livingstone should be wholly ashamed.
	We need a new London Mayor to tackle that level of dissatisfaction.

Graham Stuart: It is not surprising that the Mayor is not in sympathy with the naturally law-abiding citizens of London because in earlier years he preferred to spend time with Sinn Fein rather than with Ulster's police force. London people were prepared to forgive him that and give him a chance. They hoped that he had changed; but as he has shown that currently he prefers the company of homophobic, hate-filled extremists to that of people interested in community safety we can see why his character is not suitable to be Mayor of the city.

David Ruffley: My hon. Friend makes a typically powerful point. The current London Mayor—I hope we do not have him for too long—is tolerant not only of low-level crime but of serious crime and he should go.
	In addition to the sanctions we believe should be attendant on under-18s' antisocial misbehaviour, which breaks the behaviour code, there should be permanent withdrawal of their bus passes until they participate in a restorative justice programme to earn them back. That is an excellent and original idea proposed by my hon. Friend the Member for Henley.
	As well as those sanctions, we want more police visibility, which we can pay for in part by employing fewer press and communications officers. According to the Central Office of Information, Mr. Livingstone has more press officers than the Prime Minister, although as his popularity rating is almost as dire as the Prime Minister's we might wonder whether that is a good use of Londoners' money. Transport for London forecasts that it will spend £66 million on advertising, marketing and communications in 2007-08. It would be a sensible idea to cap that spending in real terms rather than going ahead with the £84 million requested by Mr. Livingstone. Those figures are from the Greater London authority group budget report, 2008-09. Under our proposal, £16.5 million of the money saved would be redirected to the existing safer transport teams and would pay for approximately 440 police community support officers, delivering more visible presence on our transport network—approximately doubling their strength.
	Police support officers are valued by the Conservatives; they could particularly help to crack down on one of the low-level issues identified by my hon. Friend the Member for Henley—fare evasion. Why? Punish the smaller offences and the larger ones will diminish in number. The example that we have already mentioned is New York, but there are other examples in cities around the world.
	In 2006, fare evasion in London rose from about 2.3 per cent. to 3.18 per cent on conventional buses, with a cost to the taxpayer of £36.7 million. On bendy buses, fare evasion rose by a much bigger amount, rising from 7.8 per cent. to 9.3 per cent. That is more than double the rate on conventional buses. Those are figures that my hon. Friend the Member for Henley has delved into, and they are quite worrying. The revenue loss on bendy buses alone was £8 million, and the total loss for all buses was in the region of £46 million. That is about £1 million a week in lost revenue. Every criminal who evades their fare and is not caught is a criminal who may have form for more serious offences, so the issue is not just about lost revenue.
	TFL deploys about 300 revenue protection inspectors on its entire bus network, about 200 revenue control officers on the underground, and about 200 traffic enforcement staff. Considering that there are about 7,700 normal buses and about 300 bendy buses, there is a minimal chance of people being caught, and offenders know it. We hope that a new London Mayor will be able to direct the Metropolitan Police Authority to investigate, in partnership with TFL, giving revenue protection inspectors new and better powers, including, for the first time, the power to take names and addresses, so fare-dodgers can truly be held to account.

Joan Ryan: I should tell the hon. Gentleman that we have police community support officers on our buses already. I am all in favour of dealing with what he calls low-level crime, but no one could take seriously what he and his party's mayoral candidate say about policing in London and about chairing the MPA unless they answer the serious questions that they are trying to dodge. Why did he and the hon. Member for Henley (Mr. Johnson) vote against mandatory five-year sentences for illegally carrying a gun? Why did the hon. Member for Bury St. Edmunds (Mr. Ruffley) vote against antisocial behaviour legislation? Admittedly, the hon. Member for Henley makes a very good game show host, but I do not think that he is a serious candidate for London Mayor.

David Ruffley: I am afraid that that was not a serious intervention.
	Moving on from buses to suburban railway stations, the London assembly's transport committee recently expressed its dismay at the "glaring loopholes" often
	"left in the security net"
	in relation to suburban railway stations. Many outer London station platforms are often unmanned by quite an early time in the evening.
	As I have said, I had the privilege of visiting the British Transport police today; I was with them up until this debate started. They cover a huge rail network, which extends way beyond London, with a mere 427 fully warranted officers and 303 PCSOs and support staff. In 2003-04, just over 15,000 offences were committed at overground stations, but by 2005-06, that figure had risen to more than 19,300. We propose that about £3.1 million earmarked for the MPS advertising and spin doctor budget be released to fund approximately 50 extra fully warranted officers.
	Those new officers could patrol suburban station platforms, particularly the stations with the highest levels of crime. We are talking about not just the inner city but the outer parts of London, which, sadly, the Mayor treats with arrogant disdain. He seems to think that his heartlands are in the allegedly tough, hard areas of the inner city. We want some attention to be paid to the suburbs of this great city, and the proposal of my hon. Friend the Member for Henley would ensure just that.
	Closed circuit television has been deployed and used by the London authorities, but we believe that more can be done. We propose that £150,000—a modest sum that could be found from the more wasteful parts of the Mayor's already rather wasteful budget—be used for a CCTV trial for 20 of the most dangerous bus routes in London, lasting approximately six months. The capital cost for new equipment is about £3,000 to £3,500 a bus. Running costs for the cameras, aside from the capital element, would be about £45.

Boris Johnson: It may help my hon. Friend to know that the proposal is for live CCTV on buses. As I think the right hon. Member for Enfield, North (Joan Ryan) is about to say, there already is CCTV on buses, but in only 5 per cent. of cases is that CCTV made available when a crime has been committed.

David Ruffley: My hon. Friend anticipates me. Our proposal is for instant access real-time live CCTV. It has taken my hon. Friend to come up with this innovative idea. The Mayor has had eight years in which to roll it out. Instant access real-time live CCTV would be particularly useful where a code red call is received. We could then prioritise calls that required emergency police assistance. Subject to the trial working as we believe it will, police officers would have the ability to dial into the system to see what was going on in real time, using mobile technology where that was available.
	The police could also record the footage in real time and use it as instant evidence, rather than having to wait for the bus companies to send them recorded footage, as they do at present, which wastes huge amounts of time. I heard only this morning that one of the problems—an evidential problem—is that often the Crown Prosecution Service will not charge until it has reviewed the CCTV evidence, which can take weeks to reach the CPS and the police at the station. Everybody knows that. My hon. Friend has a solution to the problem; the Labour party in London has had eight years and done nothing about it.

Keith Vaz: Has the hon. Gentleman had the opportunity to see the evidence given to the Home Affairs Committee in our inquiry on the surveillance society? He is right. There is a demand for more cameras, but there are additional costs in viewing the footage. It is not just a matter of installing the cameras and making sure that the footage is viewed live. The resources are needed to enable people to look at that footage before they make the decision to prosecute.

David Ruffley: The right hon. Gentleman is right, but he surely recognises that viewing must take place anyway. We argue that real time gives advantages, and that waiting three weeks for the hard copy to arrive through the post is not acceptable. I am not entirely sure that I understand his point.
	Thirdly, we propose that new measures on violent crime, particularly in relation to knife and gun crime, be taken. On the Mayor's own figures, 10 gun crimes a day take place in London, which is higher than when he took office. We believe that more should be done in relation to hand-held scanners. We all know that the British Transport police began Operation Shield in London to tackle the scourge of the carrying of offensive weapons, through the use of hand-held metal detectors and walk-through detection arches.
	We have looked at the Metropolitan Police Authority reserve, particularly the contingency reserve where we believe that 2 per cent. of net revenue is squirreled away. The current budget proposal includes a reserve of about 2.4 per cent. We would reduce that to 2.3 per cent. That could release up to £2.5 million for more detectors. The British Transport police are using one model of metal detector for Operation Shield. The Met have a preferred model, AD11-2, which is a lot cheaper. Depending which option we went for, our £2.5 million, which we show we can provide, would pay for up to an additional 26,000 hand-held scanners.
	Not enough cognisance has been taken by the current London Mayor of best practice established by the Association of Chief Police Officers. ACPO's Secured By Design standards result in a quarter less crime in housing estates than in non-Secured By Design housing estates. Those standards cut crime and the fear of crime. Despite Mr. Livingstone's two terms in city hall, there is not much sign of that being made a priority.
	Our fourth proposal concerns rape crisis centres. Only one for the whole of London based in zone 5 is woefully inadequate and does not acknowledge the fact that sex offences have risen in the capital. There were 546 more sex offences during 2006-07 than in 2000-01.
	We have a fifth and final proposal. We believe that the police service should be made more accountable to Londoners and we have said that for the first time there will be online crime mapping by street and neighbourhood. We have inadequate, unhelpful and difficult-to-access crime maps, of which the biggest two are in the west midlands and West Yorkshire. It is high time that the greatest city on earth had online access so that people do not have to read dodgy Government statistics, but can see crime street by street, neighbourhood by neighbourhood. That will improve their confidence in police figures and allow them to hold their local basic command unit commanders to account.
	We see a Labour Mayor and a Labour Prime Minister out of ideas and out of excuses when it comes to their failing crime record. The Opposition believe that it is possible to take the handcuffs off the police and give Londoners the law and order policies that they so richly deserve.

Tony McNulty: I promise faithfully, Madam Deputy Speaker, that I shall not call you Madam Deputy Mayor at any stage during our deliberations as I did some time ago.
	What we have just heard was quite shameful and pathetic. The hon. Member for North Southwark and Bermondsey (Simon Hughes) is right to suggest that whatever the failings of London, it does no one in the House any good to indulge in the sort of hysterical caterwauling that we have just heard, rooted in bogus statistics, invented to scare, petrify and frighten.

David Ruffley: Will the right hon. Gentleman give way?

Tony McNulty: Absolutely not, given the hysterical nonsense that we have just had, and I will come on to why it was.

David Evennett: Rattled.

Tony McNulty: I do not lose my rattle.

Madam Deputy Speaker: Order. May we please have this debate conducted in an orderly fashion?

Karen Buck: rose—

Tony McNulty: I will give way to my hon. Friend in a moment, but let me finish this point. Serious crimes are committed in London—

David Evennett: Rattled.

Tony McNulty: Not rattled. Grow up.

David Evennett: Tetchy.

Tony McNulty: Not tetchy either, thank you very much; serious.

Madam Deputy Speaker: Order. If Members wish to intervene, they should do so in the correct manner.

Tony McNulty: I am trying to inject a degree of seriousness into the debate that has been sorely lacking.

David Ruffley: Still is.

Tony McNulty: The hon. Gentleman will hang himself from his own mouth; that is not my business.
	In 2001-02, to acclamation, the Government introduced the national criminal recording standards. The National Audit Office, all professionals, everybody, said that that was a far better way to count crime. Among other things, if there was an affray in London or elsewhere before the introduction of NCRS, however many people were involved, however many victims, it would have been treated as one crime. After the introduction of NCRS, they were treated as five victims and five crimes, quite rightly. The hon. Gentleman knows that. That is why making comparisons with before 2003 is utterly erroneous and utterly bogus.
	I note that the hon. Member for Henley (Mr. Johnson) has left the Chamber. I hope that the crisis in Oxfordshire is momentary and that he will be able to join us again. He gave London about an hour in an Opposition day debate. Let us have the debate, but let us have it, as the hon. Member for North Southwark and Bermondsey suggests, on serious terms with serious figures.

Karen Buck: In the annual guide to what one pays and what one gets, my Conservative-controlled borough of Westminster records as No. 1 in its top 10 achievements for 2007-08 a fall in total crime figures, including a 6.8 per cent. reduction in burglary. Kensington and Chelsea, a borough for which I am also Member of Parliament, also announces that burglaries have been slashed and says that Kensington and Chelsea residents are less likely to be victims of burglary today than at any other time this century, and that burglary figures have halved in just seven years. Does my right hon. Friend agree that even those who dispute the Metropolitan police figures, even those who dispute the crime statistics that were all welcomed in 2000, might pay some regard to figures that have come from their own Conservative local authorities?

Tony McNulty: I agree, and my own borough is in the same position. The Opposition motion states:
	"That this House supports the dedication of police officers in the City of London Police, the Metropolitan Police Service and the British Transport Police",
	which we all do. However, there is a fine line when politicians play foolish and bogus statistical games, which, by the bye, is to treat Londoners as idiots. There is also a fine line on traducing the work of not only every single policeman and woman who is out on the beat in our capital city, but every council of whatever hue working through crime and disorder reduction partnerships to secure those figures. Does that mean complacency? No, of course it does not. Does it mean that there is not a whole lot more to do in a range of areas, which I shall discuss later? Of course it does not.
	Let us get serious about London. I do not blame the hon. Member for Bury St. Edmunds (Mr. Ruffley), who is from Suffolk and who could not care less about London. However, London Members should be serious, because it does not do London justice to play around with bogus figures.

Simon Hughes: I commend the Minister on his approach. I am not here to defend the current Mayor in the election campaign or to speak in favour of Labour policy, but a former Labour Home Secretary sought to establish an agreement across the parties with the Office for National Statistics on crime figures. Does he agree that it would be worth while to seek to do that again? Will he condemn those people in any party in any London borough who seek for party political purposes to misrepresent crime generally, and violent crime specifically, as going up, when it is going down, which increases the fear of crime among ordinary people on the street?

Tony McNulty: Many of the recommendations in the Smith review came out of that cross-party initiative on criminal statistics, which included Liberal Democrats and Conservatives, and has been implemented on my watch. Some of the recommendations have not been implemented, because there are difficult issues surrounding, for example, the definition of an assault—it involves harassment and other areas. Grown-up politicians in this House now agree on the figures. Let us—mayoral candidates and otherwise—debate the policies and the substance, but we should not debate the basic statistics, which is utterly shameful.

Nick Hurd: My constituents are not idiots, and they probably tune out the ding-dong on statistics. However, they are genuinely concerned to read that Hillingdon has the third highest crime rate in London and that crime is running at the record level of 72 crimes a day. They also recognise that public finances are considerably stretched. Will the Minister guarantee that numbers of sworn police officers will not be cut in the borough of Hillingdon and that there will be no review of the policy of full-strength safer neighbourhood teams across every ward in the borough?

Tony McNulty: I can give that guarantee, but only if Ken Livingstone is Mayor on 2 May. I cannot give such a guarantee given the erratic nature of the Conservative candidate, who has made it clear that he has not got a clue about finance and London generally.
	Returning to the hon. Gentleman, Hillingdon council—it is one of his rather than one of mine—has stated that
	"crime figures are at a 5-year low. Personal robbery is at its lowest for 3 years, vehicle crime is at its lowest for 5 years and assaults are at their lowest for 5 years."
	The hon. Gentleman should join me in congratulating Conservative Hillingdon on all it has done working with the Metropolitan police under the Mayor's tutelage to achieve those figures.

Andrew Love: Will my right hon. Friend congratulate the Mayor of London on not only the significant increase in the number of police officers in London, but the introduction of safer neighbourhood teams across the capital, which have made such a difference to crime at a local level?

Tony McNulty: Absolutely. In terms of the pace of introduction, that took place in the teeth of Conservative opposition. Conservatives said that it could not be done London-wide in the original time frame, let alone a year early. As an outer London, suburban MP—my constituency is next door to that of the hon. Member for Ruislip-Northwood (Mr. Hurd)—safer neighbourhood teams are making as much of a difference in the outer London suburbs as they are in inner London. The notion that the past eight years have all been about a zone 1 mayoralty is nonsense.

Dawn Butler: In my constituency in Brent, murders decreased from 10 to four in 2006-07, which is the reality of the extra investment that has gone into the police. The Opposition need to discuss statistics in terms of the reality for people on the ground. That is still four murders too many, but there has been a huge reduction. Will my right hon. Friend discuss the British Transport police? When Transport for London took over the Bakerloo line, there were 50 additional British Transport police, the stations were cleaned, the number of guards was increased and fare evasion was cut by more than half.

Tony McNulty: Again, I agree; my hon. Friend has mentioned another dimension. I agree absolutely that four murders are four too many—27 young people murdered are 27 too many. But again, Londoners should not be treated like idiots. If Boris Johnson is the Mayor on 2 May, that appalling—

Mr. Deputy Speaker: Order. The Minister knows what I am about to say; perhaps he would like to correct himself.

Tony McNulty: If you, Mr. Deputy Speaker, did not correct me, my right hon. Friend the Minister for London would have, according to the press—I probably owe her a fine. If the hon. Member for Henley becomes Mayor on 2 May, nothing will change dramatically in the magical way suggested by the pretty little package on crime. Most of its policies are overheated or already being done. London will deal with the issues together. It is absolutely false to suggest that the hon. Gentleman has some magic bullet, rooted as his policy is in the load of bogus figures from the hon. Member for Bury St. Edmunds.

Angela Watkinson: Will the Minister acknowledge that crime statistics from whatever source—a council, the Metropolitan police or the Home Office—have their limitations? They relate only to recorded crime. Does he acknowledge that a large amount of crime goes unreported?

Tony McNulty: Yes, of course I accept that; that is partly what the changes to the national crime recording standard are all about. However, I do not accept entirely fallacious comparisons before and after significant changes in the statistics. I agree with the import of the hon. Lady's observation: we should not be squabbling about statistics, other than when they are as flagrantly abused as they have been today. We should, and I want to, look to the policies and substantial ways in which we collectively—Tory borough, Labour borough, Liberal Democrat borough and all Members of this House—can deal with the issue so that London remains, and improves as, the best city on the entire planet.

Simon Hughes: I am very grateful to the Minister; I shall not intervene on him again. Many of us, across the parties, have tried to deal with crime in this city. It is still far too high, although it is going down. Some of us find it absolutely amazing that on a day when the Conservatives have chosen the subject and time of this debate, and allocated only three hours to it, the person whom they put forward to speak on this issue does not even give London the courtesy of being here for those three hours. That is absolutely disgraceful and symptomatic of a completely irresponsible Johnny-come-lately attitude on the part of the hon. Member for Henley (Mr. Johnson).

Tony McNulty: Let us be fair: the hon. Member for Henley gave us 40 minutes, which probably stretched his attention span. Let us not be unduly ungenerous.

Andrew Dismore: To square the circle, the hon. Member for Henley (Mr. Johnson) was hardly here the last time we debated policing in London—nor was he here for the housing debate that we had immediately before this one. I want to put to my right hon. Friend the point that I wanted to put to the hon. Member for Bury St. Edmunds (Mr. Ruffley). My right hon. Friend talked about the safer neighbourhood teams; does he also welcome the safer transport teams?
	In Barnet, we have a team of 22 officers and police community support officers. My borough commander has praised it as effective in combating crime, providing reassurance and collecting intelligence. Will my right hon. Friend condemn Brian Coleman, the Greater London assembly member for Barnet and Camden, who described the new team as a gimmick when it was introduced? How does that square with what the Conservative party says about safer transport teams? It now says that they are a good thing.

Tony McNulty: I am afraid that we get that sort of thing all the time. Much of the antisocial behaviour legislation that the hon. Member for Bury St. Edmunds prays in aid as somehow magically discovered by the hon. Member for Henley was dismissed at the time of introduction as an utter gimmick that would not tackle the real issues in London's boroughs. I fully accept what my hon. Friend says and happily condemn Brian Coleman in all sorts of ways, including for the reason given by my hon. Friend.
	For the record, I should say that £140 million a year is being spent by the Labour Mayor on transport policing. That means 1,200 officers in the transport operational command unit, 450 additional uniformed officers in safer transport teams, as my hon. Friend mentioned—mostly rooted in outer London suburbs such as his borough and mine. There are more than 700 uniformed British Transport police officers on the underground and docklands light railway and 100 such officers on the overground rail system in London. They provide reassurance and rapid deployment to crime hot spots. Furthermore, the Government have put in place a whole series of antisocial behaviour powers specific to the BTP, with the Mayor working very closely with it and the Metropolitan Police Service in that regard.

Joan Ryan: I do not know whether my right hon. Friend has yet had time to read "Enfield Council News", which tells us, as I am sure that he will be pleased to know, that the overall reduction in crime in Enfield has been 5.3 per cent. Perhaps more important than that percentage figure is the fact that that means that there are 1,386 fewer victims of crime. That is a very important figure. Not all Conservatives are as decrying or churlish about that success in fighting crime as those in the Chamber. The cabinet member for community safety and the voluntary sector, who is a Conservative member, says:
	"This is excellent news. Our colleagues in the Met have been working extremely hard to make sure that those who commit crime are caught and brought to justice swiftly and effectively".
	I echo those words. Will my right hon. Friend comment on the degree to which this is being replicated across London boroughs?

Tony McNulty: I can tell my right hon. Friend that it has been replicated across London boroughs. The most interesting thing is that three of my hon. Friends in the Chamber are from outer London boroughs—the areas supposedly being starved of resources and attention by the Mayor. I am afraid that I am a rather impatient man, so I did not wait for the latest edition of "Enfield Council News" but went on to the website, which refers to offences having fallen by nearly 10 per cent. between 2003-04 and 2006-07—a trend that continues in 2007-08. That matters in terms of substance, as it goes on to talk about notable changes such as motor vehicle crime being down by 17.6 per cent., residential burglary down by 8.9 per cent., and sexual offences down by 22.5 per cent.

Bob Neill: rose—

Tony McNulty: Those statistics matter and show what is going on in reality.

Bob Neill: Will the Minister give way?

Tony McNulty: I was not sure if the hon. Gentleman was rising—of course I will.

Bob Neill: I thank the Minister for giving way in his ever-courteous manner. Given that he claims that the Government have had so much success and invested such a large amount of resources, why were 27 teenagers murdered in London last year as opposed to 17 the year before? How is that a measure of success?

Tony McNulty: That is almost beyond contempt and quite shameful in the context of 27 times pain and tragedy for local families. The notion that the record level of police officers who are on our streets would, if somehow further increased, reduce those tragedies is complete and utter nonsense.

Bob Neill: Pontius Pilate.

Tony McNulty: No—absolutely not Pontius Pilate.

Mr. Deputy Speaker: Order. May I suggest to the House that we try to lower the temperature a little? Nothing is gained by personalising these matters or arguing for ever about statistics. I know that other things are happening outside this Chamber, but the House should also bear it in mind that this debate is really about what this House has responsibilities for. I should be grateful if the Minister and all hon. Members would bear those thoughts in mind as we proceed.

Tony McNulty: I take your admonition entirely, Mr. Deputy Speaker.
	In the third or fourth paragraph that I read, and in my response to my hon. Friend the Member for Brent, South (Ms Butler), I said that the four murders last year in her borough were four too many. No Labour Members, or, I think, Members in most parts of this House, are washing their hands of the levels of crime in this fair city of ours. To be very serious, up to about eight years ago, when we first recaptured a London police authority, and in my own Department in the '70s, '80s and '90s, there was perhaps far too much washing of hands and coping with acceptable levels of crime instead of dealing with it. That is not what has prevailed over the past 10 years, even on the sort of figures that the hon. Member for Bromley and Chislehurst (Robert Neill) introduces and overcooks. There has been a significant decrease in crime, according to the Met's own figures. That has been repeated quite happily by a range of Conservative councils throughout London, and I pay credit to them for assisting in that process, along with Labour and Liberal Democrat councils. We cannot have it all ways. We cannot traduce the figures, and by traducing them, traduce what every single policeman and woman does in service to London, nor can we have a series of policies proffered that treat London as though nothing has happened for the past eight or 10 years—as if it were year zero.
	It was suggested that we get rid of the stop-and-search account. That is going to be done. The Government accept fully what Ronnie Flanagan says about the stop-and-search account. That will be done—so nothing new there. Section 30, section 60 and section 44 stop-and-search details are being looked at as we speak. Section 44 of the Terrorism Act 2000 is certainly being looked at; I initiated the consultation myself some months ago. There has also been an undertaking by the Metropolitan Police Authority, under the Mayor's tutelage, to look in great detail at every aspect of stop-and-search in London.
	There are more police, with a greater uniformed presence on our buses and trains and in public spaces, such as stations. That process has been going on for quite a while. I had a hand in it myself some time ago, when I was the Minister responsible for London's transport and I worked closely with the Mayor. He is a Mayor who, I might say, understands entirely how much a bus costs and how much it costs to run. As a starting premise, we should accept what our police, our police community support officers, our councils and the people of London have done, working together with our Mayor.

David Evennett: I shall try to be constructive, but is it not true that the police are spending less time on patrol and on front-line policing than they were? Is the Minister looking at that, with a view to getting more police on patrol?

Tony McNulty: Yes we are, as Ronnie Flanagan said in his report and, I hope, as we will say in some depth in the forthcoming policing Green Paper in the spring. I take some of the hon. Gentleman's point to heart. More and more of our policing teams need to be out on the front line, and increasingly they are. We have heard a rather bogus slicing of figures this way and that by the hon. Member for Bury St. Edmunds, who used them rather obtusely instead of just using the figures themselves. I do, however, accept the starting premise of the hon. Member for Bexleyheath and Crayford (Mr. Evennett).
	The absolute key has been getting neighbourhood policing teams in place in every ward in London. By any token, that is an astonishing feat in the defence of law and order. It is to the great credit of the Mayor and the leadership of the Metropolitan police, and it should not be traduced lightly by Johnny-come-latelies of any description, whether they can be bothered to attend these debates or not.
	By the bye, Conservatives' debates on crime in London are rather Olympian in nature. I have checked, and this is the third Opposition day debate on crime in London that they have managed during my 10 years in the House. They come along every four years. We had one in 2000, just before the mayoral election, I understand—the hon. Member for North Southwark and Bermondsey will know far better than I. There was one in 2004, after the election, and we are having one now. We are pleased that momentarily, perhaps every four years, the Opposition show some concern about crime in London. I do not decry that, but perhaps it might be helpful if they did so a bit more often.
	We broadly agree with the other points made by the hon. Member for Bury St. Edmunds about sorting out crime in London, largely because many of them are being dealt with already. We have already made sure that the Met and other police services are moving towards ensuring that local crime information is provided so that communities can hold basic command unit commanders to account. There might not yet be a pretty little map, but if the extent of the contribution of the hon. Member for Henley to policing in London is that there should be a pretty little crime map as well as the information, God bless him.
	With regard to substance, it is quite right that more and more is being done on our transport network and in our town centres. In many areas, councils working with the police are doubling—and more—the number of safer neighbourhood teams in specific town centres. That is all built on a good record that stands up to any sort of scrutiny. It is not sufficient and does no one credit to dismiss measures as gimmicks when they are introduced, yet now say they are the best things since sliced bread.
	The Mayor of London has made it clear for some years that he wants the formula under the Proceeds of Crime Act 2002 to be recalibrated so that more goes to the Metropolitan police and local policing services, rather than to the judiciary, the prosecution or the Home Office. My right hon. Friend the Home Secretary said that she was minded to consider that, especially in the context of drug seizures, and to ensure that it happened. At the time—barely weeks ago—the right hon. Member for Haltemprice and Howden (David Davis) dismissed it as a gimmick, yet the hon. Member for Henley now apparently thinks that it is a good idea. Perhaps if the two connected now and again, we could get some consensus and have a proper debate about how that would help London.
	An enormous amount of work has been done, although it is not enough—God knows enough tragedies happen that show that it is not enough. However, the tackling guns and gangs action programme has done much work, which led to Operation Kartel. Action took place during the February half-term in 11 boroughs, supported by TGGAT, which led to a 50 per cent. reduction in gun-enabled crime compared with the same period in 2007; a 26 per cent. reduction in knife-enabled crimes; 542 fewer personal robbery offences, and the seizure of 170 weapons, a good deal of cash and a kilo of cannabis. We are already considering purchasing 200 hand-held search wands for several operations targeting those who carry weapons. Those measures are not panaceas. Taken together, they will help to drive down crime and liberate our communities from its impact.
	We are considering establishing a mediation service to prevent gun feuds from escalating. We are working with colleagues from the Department for Children, Schools and Families to try to ensure that the youth action plan and our tackling violent crime action plan knit together the contributions from a range of central and local authorities. No doubt that will be helped by the Mayor's plans to bring a further 1,000 officers into the Met and by working with London's communities to listen to and tackle their concerns, not least through the neighbourhood policing teams, which matter, as I think everyone would agree.
	In London, the security and safety of all our communities is our No. 1 priority and I contend that it is the No. 1 priority of the Mayor of London.

Andrew Dismore: I am pleased that the Mayor, if he is re-elected, has identified the resources for an extra 1,000 police officers. However, is my right hon. Friend aware that Richard Barnes, the Conservative leader of the London assembly, said that he did not think that so much money should be spent on police in London? Of course, he knows that the hon. Member for Henley (Mr. Johnson) said that the police and transport should be subjected to cuts.

Tony McNulty: My hon. Friend is right. On a range of other policies, we have heard nothing substantially new.
	The Opposition tell us that withdrawing free bus passes from young people would be new and novel, yet almost 10,000 have already been withdrawn. We are told that action under the Proceeds of Crime Act and fighting for London's assets are new ideas, yet the hon. Member for Henley voted to weaken the provisions in the Act and cannot afford us more than 40 minutes of his time. All those matters are far too important for anything other than a broad consensus on what unites us in fighting crime and offending in our communities. That consensus appears to exist among most MPA and GLA members. London is ill served by trivialisation and shroud-waving by the hon. Member for Bury St. Edmunds and the hon. Member for Henley, who will remain the hon. Member for Henley and nothing more after 2 May. I commend the amendment to the House.

Tom Brake: This is definitely the debate that Londoners want us to have just one week ahead of the mayoral elections on 1 May. Like my hon. Friend the Member for North Southwark and Bermondsey (Simon Hughes), I am astounded to see that the one mayoral candidate who could be here to take part in this debate has not taken full advantage of the opportunity. I also wonder whether some of the more diligent Conservative Members of Parliament representing London, whom I see in the Chamber regularly, might not be feeling that the hon. Member for Henley (Mr. Johnson) is letting the side down very badly.
	Like many hon. Members present, I was elected in 1997. At that time and for some years afterwards, there was a tendency among Liberal Democrat and Labour Members to blame the previous Administration for every fault that we encountered. We have moved on since then and it is now, rightly, this Labour Government's responsibility if they have failed to tackle crime. However, it is also worth reminding hon. Members of a few salient facts, because we need to consider what the Conservative Opposition are saying alongside their track record when they were last in government and in a position to deliver an agenda of cutting crime.
	Hon. Members will remember that in the five years of the last Conservative Parliament, police numbers fell throughout the country as a whole and even more dramatically in London. Hon. Members will know that John Major specifically promised to increase police numbers by 5,000, yet police numbers fell. It is perfectly legitimate to remind ourselves of those facts when we consider the pledges, plans and promises put forward by the Conservative party. The lesson that we have all learnt is that they need to be taken with a huge pinch of salt.
	It is perhaps more legitimate to consider the credentials of the hon. Member for Henley, who has put himself forward as the Conservative mayoral candidate, and to examine in what respects his experience will be relevant to being the Mayor of London. I have here a helpful crib sheet, which is being sent out across London, that sets out the hon. Gentleman's CV, which reads as follows:
	"Sacked as a Trainee Reporter for falsifying a quotation.
	Sacked as a Columnist. His Editor said 'he wasn't exactly Mr Deadline'".
	We know that he was sacked from the Conservative Front Bench—

Mr. Deputy Speaker: Order. I suggest to the hon. Gentleman that he think about the matters that we are debating today and how the points that he is making are relevant to the overall situation.

Tom Brake: Thank you for that intervention, Mr. Deputy Speaker. I had concluded those remarks. The hon. Member for Henley is putting himself forward as a candidate for Mayor, with responsibility for policing among other matters, but I will indeed move on. According to the hon. Gentleman's manifesto—he has at least produced a manifesto—he will apparently use his influence to tear up red tape and needless form-filling. Presumably what he had in mind was needless P45 form-filling, of which he has some experience.
	Let me move on to the Labour Mayor's position. The incumbent, Ken Livingstone, is keen to distance himself from the Government when appropriate, but at other times he is keen to make himself known as the Labour Mayor. We have to take the two together. I am happy to put on record the fact that the combination of the Government and the Mayor has enjoyed some successes, the biggest example of which is the safer neighbourhood teams. Like probably all hon. Members present, I have been round with the safer neighbourhood teams in a number of my wards and seen their impact on the ground. I can see that they are delivering the reassurance that people need and are beginning to eat seriously into crime levels.
	I am told that the biggest problem for the safer neighbourhood teams in some of the leafier suburbs—Government Members should please not quote me on this—is that there is no crime for them to deal with. If safer neighbourhood teams are telling me and other hon. Members, as I suspect they are, that there are times when things are relatively quiet and they would like some other challenges, we might need to consider giving them a more flexible structure.

Bob Neill: The hon. Gentleman has made an interesting point about safer neighbourhood teams. Perhaps he will be interested to learn that one of the teams in my borough, although it does excellent work, needs a safer neighbourhood base to patrol from. The Metropolitan police acquired suitable premises about six months ago and have been paying rent and rates on them ever since, but the premises remain empty because the bureaucrats at Scotland Yard made a muck-up of the procurement process and had to restart it. That money has therefore been wasted and the team does not have a base. Is not that a strong argument for a much more direct political drive and direction of the Metropolitan police service, as is being proposed by my hon. Friend the Member for Henley (Mr. Johnson)?

Tom Brake: It is certainly a case for ensuring that the procurement process works correctly. I am sure that all hon. Members support the idea, which the Minister mentioned in our last topical debate on this subject, that the safer neighbourhood teams should have bases in their wards, so that they are more accessible and visible and do not have to travel so far. The hon. Gentleman was quite right to raise that point, and no doubt he will be issuing an appropriate press release to his local paper confirming that he has quite rightly raised the matter in Parliament.
	There have been successes, but there are also some concerns. I was about to mention the estates strategy to which the hon. Gentleman has just referred. That is clearly a programme that is going to last five or six years, so, although the comprehensive spending review has given visibility to what will happen in the next three years, there is a question mark over whether the remainder of the strategy will be able to be delivered in the following three years. I do not want to have to turn round and say to people in a few years' time, "I know the Metropolitan police promised that your new police station would be opened before the old one closed, but actually they have run out of money so they have simply closed the old one and not opened the new one." We need some certainty on that question.

Simon Hughes: All these things are important, but does my hon. Friend accept that what matters most to all our constituents is that there should be an effective and speedy response when crimes are committed? For example, I still get too many complaints from people who have been attacked, perhaps in a pub or in a house, and who have found that no one comes for many minutes and sometimes for half an hour or longer. Also, we must ensure that, when an investigation takes place, it is done well. Again, I have had far too many complaints that serious allegations—including allegations of rape—have been badly handled by the police and/or the Crown Prosecution Service, with the result that justice is not done and victims are not looked after.

Tom Brake: I thank my hon. Friend for that intervention. I do not want to give the impression that everything is functioning well. We have all had examples of constituents who have been the victim of a crime and who have, unfortunately, had to wait a considerable length of time for a response. Sometimes that response has not been forthcoming at all and, ultimately, it has been the safer neighbourhood team that has had to respond a few days later. There is still a need to ensure that the response is timely.
	There have been some failures—

Chris Bryant: Before the hon. Gentleman moved on to the failures, he was talking about some successes. Does he agree that there has been another significant success in the past eight years, namely the radical transformation of the relationship between the police in London and the black and minority ethnic communities and, for that matter, the lesbian and gay community in London? This has resulted in many more people having a strong relationship with the police, which the police have been able to use in ensuring our security. Does the hon. Gentleman think that that might be threatened if the new person in charge of the police in London was someone who had referred to "picaninnies" and "watermelon smiles"—

Mr. Deputy Speaker: Order. I think that that is probably sufficient.

Tom Brake: I thank the hon. Gentleman for his intervention. Londoners, who live in a very diverse community, will be looking very carefully at what the different mayoral candidates have said, and I think that they will draw their own conclusions from the comments that have been made in the past. Our candidate, Brian Paddick, has certainly done his best to support the work that the hon. Gentleman describes and to ensure that those relationships with the black and minority ethnic communities and the lesbian and gay communities are enhanced and strengthened.
	I am afraid that I was about to come on to some failures. We had a pledge in 2005 to increase the number of community support officers to up to 24,000—a pledge that has been reduced to 16,000, with a direct impact in London of a reduction from 6,400 to 5,600 such officers. Serious concerns were raised by Sir Norman Bettison of the Association of Chief Police Officers when he gave evidence to the Home Affairs Committee a couple of days ago. He spoke about a funding gap, particularly for tackling serious and organised crime.
	Members have referred to another significant problem—that of gun and knife crime. I take the Minister's point and I am not going to say that it is all down to police numbers, but clearly the problem is increasing and it is particularly significant for young people, whether as perpetrators or victims. It may not all be due to police numbers, but it is a problem that needs to be resolved, whether by the Government, local authorities, communities or, indeed, individuals.

Harry Cohen: I would like to raise with the hon. Gentleman the issue that I raised with the hon. Member for Bury St. Edmunds (Mr. Ruffley): the matter of the Mayor's London youth offer of £79 million. I praise the Mayor for that, as it was greatly needed. The Conservative Front-Bench spokesman said that the Conservatives would not cap it, but does the hon. Gentleman feel that there is a real risk of their redistributing it away from the deprived areas where there is youth gun and knife crime into the more leafy suburbs where it would not have the same effect?

Tom Brake: I thank the hon. Gentleman for his intervention. I am afraid, however, that it is not really appropriate for me to respond to a point about what a future Conservative Mayor—if, indeed, there ever is one—intends to do with funding. The hon. Gentleman has, however, reminded me that the Home Office needs to address one particular aspect of tackling gun and knife crime—the research carried out into the effectiveness of different projects. The range of projects currently runs from perhaps a single ex-offender who has taken it on his or herself to organise something at a very local level through to much larger funded projects. On the basis of a conversation with a member of the Metropolitan Police Authority, I know that not much research has been done into which of those projects really deliver and which deliver value for money. I hope that when the Minister responds, he will be able to say a little about what research the Home Office is either carrying out now without my knowledge, or intends to carry out to assess which projects deliver the best value in tackling this very serious problem.

Andrew Love: This is, indeed, an incredibly serious problem. I want sincerely to ask the hon. Gentleman whether there are any shortcomings in what the authorities are doing—I mean the Metropolitan police or the Government through their violent crime action plan or various other initiatives, including those talked about by the Mayor and others—to take young people off the streets and give them an alternative to the gang culture. Are there any other things that we should be doing to try to address what is an extremely serious problem for London?

Tom Brake: I thank the hon. Gentleman for his very helpful intervention. I have just highlighted one thing that we should be doing—looking at the different projects and assessing which are the most effective in tackling the problem. Another proposal that I would put to the hon. Gentleman is the idea of giving one of the officers in the safer neighbourhood teams specific training in youth issues in order to provide the link with young people. If it were needed to deal with disadvantaged youths or others outside the system, an officer would then have the necessary training to make contact and perhaps forge a more positive relationship with them. Those are two proposals that I would put to the hon. Gentleman.

Angela Watkinson: In my constituency and, I am sure, those of most other London Members, there is a range of activities in which young people can involve themselves, such as clubs run by the council, young people's uniformed organisations such as the scouts and guides, art, sport, music and drama. The problem is not a lack of facilities, but the fact that a hard core of young people do not want to participate.

Tom Brake: I agree. Provision varies from one local authority to another, but many provide a variety of options for young people, for instance through youth centres or uniformed organisations. As the hon. Lady says, there is a group who will not take advantage of such services, but we might be able to find ways of providing diversionary activities in which they do want to participate. If that means giving them authorisation to do parkour running around an estate, perhaps we should facilitate the process. We need to ensure that the range of options offered to young people allows them all to access activities that interest them.

Simon Hughes: Will my hon. Friend give way?

Tom Brake: I will give way once more; then I think I should make some progress.

Simon Hughes: I wanted to respond to the last three interventions. I know that the Government are considering whether, rather than change the membership of a safer neighbourhood team, they should enable someone who has the skills to target characters who need work to carry out detached youth operations in each ward. That person would focus particularly on young people between 15 and 21 who are not employed, studying, training or in an apprenticeship, because they are the ones who give the grief: they can afford to be out all night causing trouble because they have nothing to do in the daytime.

Tom Brake: I agree. That echoes what was said by the hon. Member for Upminster (Angela Watkinson) about the hard-core group who are not in the system and do not want to be, but with whom it might be possible to engage if they were offered appropriate activities. Perhaps the Minister will be able to update us on what is happening to dormant accounts. I assumed that they would start to provide a level of funding that is not in the system at present, and might create opportunities for engagement with that group of people.
	I have described some Government successes and some areas of concern and failures. Regrettably, there are also some areas of spin. I am afraid that the only reason why we shall not be able to support the Government amendment is a phrase to which other Members have referred, suggesting that the House
	"welcomes the aim of the Mayor of London to add 1,000 more"
	police officers. We cannot support that proposition, because we know that it is not the Mayor who will be doing that. It is the boroughs and the Home Office. We need some honesty about who will provide funds. The Mayor will not be providing those 1,000 extra officers, and I think that credit should be given where it is due.

Justine Greening: Might not another piece of honesty have appeared in the amendment—the admission that band D taxpayers in London who were paying around £55 a year in precept to fund the Met in 1996 and 1997 paid £224 in 2007-08? My part of town, Wandsworth, has fewer warranted officers patrolling the streets than it had a decade ago, and we do not think that we have been given value for money.

Tom Brake: I recall that the hon. Lady made the same point during a topical debate a few weeks ago. There is clearly an issue over the gearing of the precept—how much it contributes in real terms, and how much is contributed by the Home Office. But we need a visible police presence on the streets, and the hon. Lady is right to argue on behalf of her constituents that there should be more visible deterrence.

Andrew Slaughter: While we are at it, could we have a third piece of honesty? Should not the Conservative party admit that it opposed funding increases? Conservative councils—and probably Liberal Democrat councils as well—consistently take credit for the falls in crime for which they opposed funding, and continue to claim that tax rises are unnecessary when they are exactly what paid for those extra police officers.

Tom Brake: I seem to be playing piggy-in-the-middle, trying to act as a third party and defend a policy that is not ours. Perhaps the hon. Gentleman will find an opportunity to intervene on a Conservative Member and make a similar point.
	We do require honesty in the debate and in how the figures are produced. My hon. Friend the Member for North Southwark and Bermondsey made the valid point that we need to agree which statistics are firm and fair, and reflect the changes that have been made to how crimes are counted, so that the debate is not about the statistics but about how officers are deployed or whether they are doing too much administration. That would be better than a rather sterile debate about the statistics.
	I hope that Members on both sides of the House would agree that the British crime survey figures provide us with a consistent level of reporting for crime and may therefore be much more accurate than other figures. They are not dependent on a change to the way in which the offences are calculated. Regrettably, it is clear from those figures that London as a region is doing very badly compared with other regions, whether on violent crime, vehicle crime or burglary. There is an issue as to how London compares with other parts of the country, even if the background is that crime is falling. London still has more than its fair share.
	On 1 May, Londoners will choose whom they want to put in charge of the police, to cut crime and to tackle antisocial behaviour in our capital city. They could choose the hon. Member for Henley, who in his first six years in Parliament expressed no interest in London. We looked at all the parliamentary questions that he had tabled and not one of them—

Clive Efford: Just one.

Tom Brake: I apologise. The hon. Gentleman tabled one question about London in six years, but Londoners will not be taken in by that. He seems to have more experience of flouting the law than of imposing it. If anyone wants to challenge me on that point, I refer back to the leaflet that I mentioned earlier, which shows the hon. Gentleman riding his bike while making a mobile phone call.

Andrew Dismore: The hon. Gentleman has been coruscating about the mayoral pitch by the hon. Member for Henley (Mr. Johnson). Perhaps the hon. Gentleman could say how he would advise Liberal Democrats to use their second preference vote.

Tom Brake: It will come as no surprise to the hon. Gentleman that I shall not express a second preference.
	Then we have the Labour Mayor, who four years ago promised to cut crime by 50 per cent., but who, at the last count, had delivered only an 18.5 per cent. reduction in crime. Or we have the ex-policeman Liberal Democrat candidate, Brian Paddick, who has 30 years of experience in tackling crime, from the Brixton riots to cracking down on hard drugs dealers. Even Conservative and Labour Members will realise that the choice is a no-brainer. Brian Paddick has the serious solutions for London and that is who people will vote for on 1 May.

Clive Efford: Crime has fallen in each of the past five years. It has fallen by an average of 5.5 per cent. in the past three years, despite what the hon. Member for Bury St. Edmunds (Mr. Ruffley) said in his opening remarks. Those are the irrefutable facts about policing in London.
	We can bandy figures around, but a trawl around the websites of Conservative local authorities in London makes interesting reading. They are not consistent with anything that we have heard from the Opposition today. Barnet council says that it has seen a 17.5 per cent. reduction in crime between 2005 and 2008. Croydon council boasts that the borough has experienced a 5.2 per cent. decrease in recorded violent crime. Enfield council states that offences have
	"fallen by nearly 10 per cent. between 2003-04 and 2006-07".
	We are grateful to Councillor Greg Smith of Hammersmith and Fulham council, who welcomed the safer neighbourhoods teams rolled out by Ken Livingstone. He said:
	"More Bobbies in Fulham Broadway and Shepherds Bush Green are resulting in more arrests and less crime, with no evidence of any displacement to neighbouring wards. We have seen some staggering results, for example, in Shepherds Bush, robbery is down by a colossal 46 per cent and in Fulham Broadway, total crime is down by 10 per cent, with burglary down 27 per cent."—

Justine Greening: Will the hon. Gentleman give way?

Clive Efford: I am coming to you, don't you worry.

Mr. Deputy Speaker: Order. I counsel the hon. Gentleman to use the correct parliamentary language.

Clive Efford: I am coming to the hon. Lady.
	Harrow council carried out a crime survey and found that 71 per cent. of residents surveyed felt safe. The council said that
	"residents' fear of crime, and perceptions of anti social behaviour, have shown significant improvement year on year for the last three years."
	Havering council—the hon. Member for Hornchurch (James Brokenshire) might want to use this when he sums up—states:
	"Although Havering is an extremely safe place to live, the fear of crime is higher than the probability of being a victim of such a crime.
	We are committed to tackling fear of crime through educating the public about the facts and ensuring they are not overtly frightened by stories that might appear in the newspapers and on television or the radio."
	I say to the hon. Member for Hornchurch that we could add "in  Hansard", could we not?
	Hillingdon says on its website— [ Interruption. ] I am quoting your colleagues in support of my argument.

Mr. Deputy Speaker: Order. I do not want to keep intervening on the hon. Gentleman, but he must use the correct parliamentary language.

Clive Efford: Thank you for correcting me, Mr. Deputy Speaker. I am using the colleagues of the hon. Member for Putney (Justine Greening) to highlight the fact that they do not agree with the arguments being put from the Conservative Bencher.
	Hillingdon council boasts that
	"crime figures are at a 5-year low. Personal robbery is at its lowest for 3 years, vehicle crime is at its lowest for 5 years and assaults are at their lowest for 5 years."

Justine Greening: On a point of order, Mr. Deputy Speaker. I have been trying to intervene to set the record straight. Can you give me some guidance on whether it is appropriate to read a quote from, for example, Hammersmith and Fulham council but to omit to mention that the council has funded additional police officers and could have been talking about that fact?

Mr. Deputy Speaker: That is not a matter— [ Interruption. ]

Justine Greening: I am asking for guidance.

Mr. Deputy Speaker: Order. The hon. Lady will get my guidance. That is not a point of order for the Chair, but a matter for debate.

Clive Efford: Kensington and Chelsea council says that burglaries have been "slashed", and that
	"Kensington and Chelsea residents are less likely to be a victim of burglary today than at any other time this century."
	I come to Redbridge council—is anyone from Redbridge? The council welcomes the reduction in street crime by a third and attributes that to the safer transport teams, which are part-funded by the Mayor of London.
	Wandsworth council says:
	"Despite recorded crime falling in the UK and burglary at its lowest for decades in London, research shows that a third of people believe crime has risen 'a lot'.
	By helping to make people feel safer in their community, Safer Neighbourhoods Teams will provide reassurance to help bridge this gap."
	Clearly, Wandsworth council regrets the fact that Conservative members of the Greater London authority consistently voted against the Mayor's budgets that introduced the safer neighbourhoods teams.

Justine Greening: I am pleased that the hon. Gentleman has finally allowed me to intervene, given that he has been talking about my constituency. I was trying to make the point that the crime survey that I carried out, to which more than 3,000 people responded, showed that people felt less safe in their area. The hon. Gentleman has failed to mention that my council and I, as the local MP, have campaigned tirelessly to get back the lost police officers—we have had fewer police officers over the past decade. The hon. Gentleman is selectively taking points from what the councils are saying and giving an erroneous picture to suit his own ends.

Clive Efford: I am slightly confused, as I used the words of the Conservative-run Wandsworth council—"despite recorded crime falling". What is erroneous about that? Is the hon. Lady saying that the information on the council's website is erroneous? Does Wandsworth council want to mislead people about crime falling in the area? Is it wrong for it to claim that the incidence of burglary is at its lowest for decades?
	The council states that research shows that a third of people believe that crime has risen, and that is consistent with the point made by the hon. Lady, but it also says that the safer neighbourhoods teams will provide reassurance. Where is the consistency in the Opposition approach to these matters?

Andrew Dismore: My hon. Friend began his contribution by referring to Barnet council, but I think that the figures that he gave are out of date. That is not surprising, as the up-to-date figures show that crime in Barnet has fallen by 24 per cent.

Clive Efford: There we are: crime in London is falling even as we speak.
	We need to put the figures in context, and to do that we have to recall that there once was a Conservative Government. That is not easy to do, but we must not forget the lessons that we learned at the time. Under the Conservatives, police numbers in London peaked at 28,455, but then, on 1 September 1994, the Government implemented the Sheehy report, and police pay was cut.
	When I was first a Member of Parliament, two police officers who worked in Camden borough visited me in my surgery. One was earning £4,600 a year less than the other because he had been employed after the Sheehy report was implemented. What impact did Sheehy have? By March 1995—six months after it was adopted—police numbers in London had fallen by 1,800.
	When this Labour Government came to office in 1997, the police training college at Hendon was empty. Police officers could not be recruited because they were not being paid enough. The first thing that this Government had to do was sort out police pay. As soon as we made the money available to employ officers, police numbers started to rise.
	Police numbers in London have increased consistently under this Labour Government, and crime has fallen in response. Since 2002-03, almost every type of recorded crime has fallen, in line with the extra police numbers funded by this Labour Government and our Labour Mayor.

Bob Neill: The hon. Gentleman is interested in history, so will he ask the Home Secretary to tell the House about the impact that the Government's failure earlier in the year to backdate the police pay award has had on police recruitment and retention in London? Would not some more recent history be useful in the debate? After all, I am sure that he would not want to risk it being suggested that he was the pot calling the kettle black.

Clive Efford: I sometimes wonder where the Conservatives come from. If they ever talked to police officers in the community or knew anything about the safer neighbourhood teams, they might join me in complaining about the loss of our community support officers. The fact is that they are applying to become police officers.
	If we are to have any consistency in safer neighbourhood teams, we cannot use them as a training ground for police officers. Intelligence about and knowledge of a local area cannot be built up in a few months, and if someone moves on rapidly they never get that intelligence and we never get the full effect of safer neighbourhood teams. My complaint is not about police numbers but about the churn in police community support officers. Many go on to become police officers, because we are recruiting more and more. That means that we lose the intelligence and the knowledge of local areas that we need, which are vital to safer neighbourhood teams.

Harry Cohen: My hon. Friend has made some very good points, but may I put it to him that he has not quite set out the whole picture of the history? For a start, he has missed out the fact that under the previous Conservative Government, overall crime doubled. Is that not a point that Londoners should take into account? Secondly, he seems to imply that police numbers have gone up because of police pay. That is certainly a factor, but is there not also an aspect of political will, from both the Government and the Mayor of London, who has put money for more police in his budget and his precept?

Clive Efford: Absolutely. The Mayor has to be commended for the resolute approach he has taken to delivering what people in London have told all of us, of whatever political persuasion, is their priority: community safety and more police on the streets. The Mayor has delivered that and had the political guts to stand up and say that if we are to have it, we must pay for it. He has put it in the precept, and people can see where the money has gone.

Angela Watkinson: May I take the hon. Gentleman back to the matter of PCSOs? He said that he regretted that some are training to become police constables. Does he not think that it should be for each borough commander to decide the balance between PCSOs and constables and to allocate his own establishment budget, rather than have the decisions made centrally for him?

Clive Efford: I do not really see that as a major issue. The fact is that people would rather have police officers than PCSOs. We all understand that, but when people begin to understand the role of community support officers, they value them equally. PCSO numbers have grown rapidly in London, and people are getting used to them. Borough commanders should have some flexibility, but they should also be accountable to local communities. Communities should know what they are entitled to get, and having a model of safer neighbourhood teams helps. There are safer neighbourhood teams of different sizes in my constituency, due to the action of my local police commander. However, a minimum number should be set so that people understand what they are entitled to.

Angela Watkinson: rose—

Andrew Dismore: rose—

Clive Efford: If the hon. Lady does not mind, I shall give way to my hon. Friend and then make some progress.

Andrew Dismore: I have just a short point to confirm what my hon. Friend said about police recruitment. As he knows, I represent the area where the training college is situated. When I was first elected in 1997, recruits rattled around like peas in a pod. Once the pay went up, the training centre was full. That is anticipated to continue, and the police are about to take leases on a block of flats opposite, which is being developed into 250 flats for the foreseeable future. That shows that they anticipate that recruitment trend continuing, even though officers spend far less time at the police training college than they used to because they train more on the job.

Clive Efford: I am grateful to my hon. Friend, who illustrates the fact that there is more to recruiting police officers, and to the cost of doing so, than just paying for them. The infrastructure has to be put in place to get qualified police officers.
	It is a shame that the hon. Member for Bury St. Edmunds is not in the Chamber, because if he were he could intervene on me and clarify exactly what he was on about. He said that he wanted to get rid of stop-and-account forms. I hope that I did not hear my hon. Friend the Minister incorrectly, because I would find it extraordinary if we were to get rid of the forms completely. I went to see my borough commander and local inspector to talk about the forms and how we could get our safer neighbourhood teams and police officers out on the street, rather than having to spend too much time on bureaucracy. They sent downstairs to have the form brought up and we went through it. I said, "Wouldn't you want to get rid of this form?" He said, "No, absolutely no way. This form provides us with a lot of intelligence. If we stop someone, take a brief description of them and later on find that a crime was committed by someone who fits their description, we have a record that we can follow up." That approach has led to the clearing up of a lot of crime in local communities. The idea that the forms are a waste of time and resources is completely bogus. It is not accurate at all.
	The hon. Gentleman said that the Conservatives would spend money on hand-held scanners, so will the police stop people in the street, scan them with no explanation, keep no record of who has been stopped and why and let them go on their merry way? When there is an incident the police will have no record of who has been stopped. If somebody wants to check why they were stopped and make a formal complaint there will be no formal record of what has taken place. It does not make sense. It does not add up. The Conservatives say that they want to get rid of bureaucracy and to make the police more effective, but they would take away a tool that is essential for the operational efficiency of the police. They claim that they want to make the police more accountable, but they would take away the form that allows an individual to check why they were stopped and what intelligence was gathered about them.

Andrew Slaughter: Does my hon. Friend agree that by reducing police accountability over stop and search the Conservative party is aiming for a return to the bad old days of the 1980s when there was no trust between many communities and the police, which was a recipe for poor policing? Local Conservatives in my area have said exactly that, and it is to be deplored.

Clive Efford: I agree absolutely. People from all sections of our communities need confidence in their police force. Stop and search was one of the things that undermined not only the relationship between police and local communities but police efficiency. To go back to it would be a retrograde step.
	As the Member of Parliament for Eltham, I paid close attention to the issues brought out by the Macpherson report. One of the factors that came out loud and clear from members of ethnic minority communities was that they wanted better and more police accountability. Woe betide anybody who wants to go back on that in the future.
	My local authority wants to deal with the rise in crime among young people, which is clearly a problem. Young people are the victims of crime committed by young people and everyone is rightly concerned about that. My local authority will invest £1 million in setting up a taskforce to tackle the problem in partnership with the local police, but local Conservative councillors oppose the plan even though it is a priority for the whole community. If we ask people what concerns them most about crime in their community we realise that it is not necessarily fear of being a victim of crime; they are actually concerned about young people.
	We are attempting to deal with the problem. Young people have been murdered in Greenwich and the council is responding, but the Conservative response to that attempt to work in partnership with the police is to oppose the £1 million investment and say that the Mayor should pay for the taskforce. That is okay, but I cannot see £1 million for tackling those crimes in Greenwich in the Conservative mayoral candidate's budget for London—I cannot see it anywhere. Again, there is inconsistency and local opportunism from the Conservatives.
	My final point is about leadership. We have talked about stop and search and the confidence of ethnic minority communities. It is essential for police operations that the police have the confidence of all sections of our community. If the Mayor is to be the chair of the Metropolitan police authority, as the hon. Member for Henley (Mr. Johnson) tells us, he will be at the forefront, encouraging people from all sections of the community, including ethnic minority communities, to join the police force. If he attends a parade at Hendon police training college, will he expect the qualified police officers who are turning out to celebrate him, their having been called "flag-waving picaninnies"? Would he expect any black police officers to smile at him— [Interruption.]

Mr. Deputy Speaker: Order. I have already said to the House that the tone of the debate should be thought through very carefully by Members. If the hon. Member is bringing his remarks to a conclusion, as I suspect he is, he might want to bear those comments in mind before he finishes.

Clive Efford: I will take your guidance, Mr. Deputy Speaker, but this is an important issue for London. We are talking about someone who wants to—

Mr. Deputy Speaker: Order. The point that I am making is on an important issue for the House. I wish the hon. Gentleman to take my remarks very seriously.

Clive Efford: Mr. Deputy Speaker, there is no denying that the remarks that I quoted were written down. They are on record for anyone who wants to read them. The fact is, Mr. Mayor—[Hon. Members: "Mr. Deputy Speaker."]—Mr. Deputy Speaker, is that the debate is taking place because the Conservative campaign for London Mayor has faltered, and the Conservatives are desperate to try to score some political points. Their candidate is fraying at the edges. In every public debate, he humiliates himself. The man has had an Eton and Oxbridge education but cannot add up; there is a £440,000 hole in his budget. He wants to pay for extra police community support officers, but the money is not there. There is a £140 million hole in his transport budget. Out of generosity, we should start a campaign to get back the money spent on his education, as it was clearly wasted. That is clearly the biggest crime to debate tonight. This debate is taking place because the Conservatives' campaign has faltered, and we have proved why it has done so in this debate on crime in London.

Lee Scott: I hope to please hon. Members in all parts of the House with my speech, as I do not intend to read statistics or to insult any candidate standing in the mayoral elections next week. I am sure that everyone in all parts of the House will know who I am supporting: the hon. Member for Henley (Mr. Johnson).
	I start by paying tribute to my local borough commander, Dave Grant, and his police force and police community support officers, who do a wonderful job in my constituency of Ilford, North, and across Redbridge. The hon. Member for Eltham (Clive Efford) read out statistics relating to my local borough and said that in Redbridge crime had dropped. We should commend the Conservative council in Redbridge for taking over when the Government stopped its funding for street wardens, and for paying for those wardens with local taxpayers' money, and not from the Mayor's budget. We should pay full tribute to those who deserve it—to Councillor Weinberg and the council in Redbridge.
	People want to hear us discussing today the issues that are important to them. Putting aside what the statistics show, last Wednesday night I attended an area committee and a crime forum in my constituency, and I heard people say what they are honestly concerned about. That is what I want to talk about today. Whether we are talking about crime or a fear of crime, people are worried. Elderly people come to me and say that they are concerned about going out in the evenings. Recently, I went round some of my local underground stations. My constituency has one of the highest number of underground stations of any constituency outside central London. I was quite upset to find that some of them are not manned; there was no one there. We recently found that some CCTV cameras, the introduction of which was lauded by all, including me, were not actually plugged in. They were not recording anything, either live or for playback later.
	We have to be realistic, and we have to react to the issues that our constituents across London are concerned about. Colleagues in all parts of the House will forgive me if I say that sometimes I get concerned, and that I fully understand why people do not vote in any elections—a problem that we should all be worried about. The reason they do not vote is the way we conduct ourselves sometimes. On occasions, we should be ashamed of ourselves for that.
	Bus usage has gone up, which is good. Train usage is up, too. However, crime relating to buses and trains, no matter how low level it is, is going up, too, and it has to be tackled.
	What do I mean by that? A few weeks ago I was at a station in my constituency where I felt intimidated by groups of youths hanging around. I am sure the hon. Member for Leyton and Wanstead (Harry Cohen) will understand what I mean, because the station is only a few stops from his constituency. If I felt intimidated—I like to think that I can look after myself—what would somebody more elderly or, indeed, younger, feel?
	The police should be given the powers that they need. On a recent occasion I accompanied my local police force. They made an arrest and spent hours afterwards filling in forms. That is wrong. As was said earlier, the handcuffs should be taken off our police and they should be allowed to do the job that they are there to do and arrest criminals.
	In the outer suburbs of London antisocial behaviour is a major issue. I do not believe that many of the youths who congregate want to commit crime or even mean to commit crime. They do not realise how they intimidate people in various housing areas in my constituency. I met them one Sunday and asked whether they would like their grandparents to experience the sort of abuse and intimidation to which they were subjecting people. None of them wanted that. I asked them what they wanted. They wanted an area where they could play football and an area where they could be away from other people.
	Again, I commend the London borough of Redbridge under its Conservative administration for building a skate park and a cycle track and for setting up a drop-in centre where the youths can go, to stop some of the antisocial behaviour. In the area where that had happened, the ward had seen a dramatic drop of up to 60 per cent. in antisocial behaviour. I believe that that is due to the input going in, backed by councillors of all political parties on Redbridge council.

Harry Cohen: I agree with the hon. Gentleman's initial comments and join him in paying tribute to Chief Superintendent Dave Grant and all his officers in Redbridge. Is not one of the key matters the London Mayor's youth offer, which would give Redbridge more than £1 million for the youth facilities that, I agree, are so needed in the borough? The hon. Gentleman keeps paying tribute to the local Conservative council, but it has cut grants to the voluntary sector by 5 per cent., some of which would have dealt with young people, and it has had a failed policy on swimming pools. I think there is just one swimming pool in the whole of Redbridge. Young people could use swimming pools if they were available in the borough.

Lee Scott: I thank the hon. Gentleman for his comments. I should be delighted to answer his remarks about swimming pools. There are two swimming pools in Redbridge, one of which has major health and safety problems. The council is committed to building a new swimming pool to replace it. Unfortunately, that is opposed by the Labour councillors in the London borough of Redbridge, but the council is pressing ahead none the less.
	On funding, I agree with the hon. Gentleman. I heard my hon. Friend the Member for Henley (Mr. Johnson) give a commitment that he would not cut the funding, and I heard nothing about any redistribution. He said that the funding would not be cut.
	I shall move on, as I am aware that others wish to speak. Businesses and people in my constituency tell me that low level crime is not being reported, for a number of different reasons. It could be because people cannot get through to the police. That is no fault of the police, who are trying to react as best they can with the powers that they have, and they have to set priorities. A lot of crime—I do not like to call it petty crime, because it is not petty to the victims of it—is unreported. That skews the statistics, but I shall not go into the statistics because I do not think that matters. People in London believe that crime is an issue. We are duty bound to tackle it. Whoever is Mayor of London on 2 May is duty bound to tackle it. I, for one, pledge to do everything I can to do so.

Several hon. Members: rose —

Mr. Deputy Speaker: Order. Before I call the next speaker, may I say that we do not have a great deal of time left? If contributions are brief, I will try to call as many hon. Members as possible.

Karen Buck: Three children have died as a result of knife crime in my constituency in a little over a year—Kodjo Yenga, Jevon Henry and Amro Elbadawi. I have sat with the parents of the two children who were my constituents, as has Ken Livingstone, who made a private visit, not making political capital, unaccompanied by the media and cameras. I have listened to their grief and to what they had to say about young people and the culture and the problems that have led in some instances to gangs and in some instances to conflicts that have got out of hand.
	This problem, which has claimed the lives of 27 young people, is monstrously misrepresented as a failure of the Mayor of London and the Government. It has its roots in something wider and deeper, which requires a co-ordinated, strategic and investment approach, on which we must all work and reflect on the gravity of the situation. We should by all means have a political debate about why such things are happening, but we cannot reduce this to slogans, as we have sadly heard again to some extent this afternoon.
	It is distressing to have listened to the mayoral debates, to have watched some of the media coverage of the mayoral contest and seen the Mayor of London accused of ignoring, belittling and failing to grasp what has happened to our young people. An example of that was when a London newspaper ran a story in January 2008 saying that Ken Livingstone had announced new measures to deal with youth and knife crime, and then a week ago ran a story saying that he was speaking out for the first time on knife crime. I do not have the articles with me, but that is part of a calculated misrepresentation of the response of the Mayor of London and other agencies to a deeply worrying trend that we must deal with together.
	In response to that, we must continue with that non-accidental choice of investing in effective policing on the streets—the 10,000 additional police officers that have been put on the streets of London by the Mayor and the Government since 2000, reversing the long-term trend that my hon. Friend the Member for Eltham (Clive Efford) described so clearly as having gone into reverse in the 1990s. Our safer neighbourhoods police are doing a superb job, not just in helping to bring down crime, as they have done, but in building up relationships and intelligence about what is happening in the streets, which is so important.
	They must continue to use their enforcement powers as effectively as they can and we can constantly refine the strategies for so continuing, as the Flanagan report helps us to do. They must use the new powers that we have given them, including stop and search, which is a vital tool, and stop and account, and they must ensure that never again do we return to that calamitous collapse in confidence and trust between the communities, particularly our minority ethnic communities, and the police that occurred in the 1980s, because that does not work. Whether people choose to bandy around the term political correctness, as they so frequently do on these occasions, let us just remind ourselves that that collapse of trust, confidence and community intelligence leads to more crime and lower detection rates. It fails on its own terms. We must all do better, which includes my local authorities, at integrating services and information between schools, youth services, housing managers, residents and the police. We must continue rebuilding our youth services, which were shattered, and the £79 million investment by the Mayor will help. It is no good having youth clubs, if they are not open.

Angela Watkinson: Will the hon. Lady give way?

Karen Buck: I will not, because I want to finish my contribution to allow others to participate.
	It is no good having youth services, if we do not have skilled outreach workers on the streets. We must ensure that we have not only warm words, but money to increase access to sport, rather than introducing charges that deter people from taking part.
	I urge the Minister to laugh in the face of the dismissal by the hon. Member for Henley (Mr. Johnson) of the
	"anti-yobbo programme, parenting classes and all"
	and press ahead with preventive work with families. Unusually for me, I support the leader of Westminster City council, Sir Simon Milton, on this issue, who has said that he wants
	"to continue important work tackling family breakdown...meeting the desperate need for support to improve their and their children's chances of living positive and fulfilling lives."
	He clearly disagrees with the dismissal of parenting classes and family work advocated by the hon. Member for Henley.
	Crime is coming down, because extra policing works. It has not happened by accident; it has happened because we have invested in the police, youth services and preventive work. Every crime is one too many, but it is critical that we do not fall into the trap set by Conservative Members, who say that nothing works and that nothing can be done. They selectively quote statistics to try to indicate that crime is rising, when crime is falling.

Justine Greening: I am grateful for the opportunity to contribute to this important debate on an issue of great concern to many of my constituents, who regularly get in touch with me about it. Like many hon. Members, I have been disappointed by the tone of the debate. I am also disappointed that I am again the only Wandsworth MP to contribute to a debate about crime in London, which is a concern not only for my constituents, but across my London borough. My constituents have a number of concerns about crime. They are worried about their children; they are worried when they come home from work late, which I do when we have late votes here; and my constituents who run businesses are concerned about the lack of policing when they open their shops late, which I shall briefly discuss later.
	Although we have heard a lot of talk about safer neighbourhood policing—we welcome our local safer neighbourhood teams—beat policing is nothing new. For years, having the police out in the community has been the bedrock of keeping crime down in communities across England, let alone London. The Government have rebranded beat police as safer neighbourhood teams, but community beat police officers are critical whatever name is used to describe specific teams in specific wards. In my part of London, we have to wait far too long for our safer neighbourhood teams to get their full complement. As I have said, compared with the number of warranted officers in the Wandsworth borough command unit a decade ago, we have fewer officers. We have police community support officers, who play a vital role in tackling crime locally, but they were never meant to be a substitute for the officers whom we have lost in Wandsworth. When my constituents find that their London precept for the Met has quadrupled to fund a lower level of warranted police officers in their local community, they do not think that they have got a good deal.
	The officers work extremely hard. I pay tribute to the safer neighbourhood team in Roehampton, which is led by Sergeant Pete Salmon. Given the number of officers, it has done a fantastic job in getting out into the community. They work with the local community in not only places such as the Alton estate and the Lennox estate, but the university of Roehampton, which forms an increasing part of the Roehampton community as it grows. The team's problem—and one that we as a community have in areas such as Roehampton—is that although it works hard, there is not enough of a police presence alongside it. I am thinking not only of the day time, when many of the safer neighbourhood teams operate; I am thinking particularly of the night time, when there are an increasing number of crime-related issues across my constituency. Safer neighbourhood teams that patrol during the day are simply not there at night, so they cannot address those issues.
	I particularly want to talk about local businesses. Like many London constituencies, my constituency, which includes places such as Putney, Roehampton and Southfields, does not contain large companies. The lifeblood of our local economy is small businesses, which are particularly prone to crime. The window of the Putney Tandoori on the Lower Richmond road, for example, has been smashed two or three times. Time and money has to be spent, and the shop has to be shut down, for the windows to be repaired. That has a real impact on the profitability of a business. When businesses on Danebury avenue are constantly being raided, the circumstances do not make for viable businesses; I know that Greggs bakery there has had such problems. If we are to regenerate parts of London—and we certainly want to regenerate Roehampton—clamping down on crime and making sure that people feel safe at any time of the day or night is really important.
	My concern about today's debate is that it has not been on behalf of people; frankly, too much of it has been about point scoring by the Labour Benches. If any of my neighbour MPs in Wandsworth had been here to speak in this debate, they would have been able to make the points that the hon. Member for Eltham (Clive Efford) was left to read out. I look forward to finally having a debate on crime in London in which my colleagues—

Andrew Slaughter: On a point of order, Mr. Deputy Speaker. That is the second time that the hon. Lady has criticised fellow Members, including my hon. Friend the Member for Tooting (Mr. Khan), for not being here. She knows full well that he is a Whip and cannot take part in this debate. Her point is very unfair.

Mr. Deputy Speaker: Comments about who is or is not in the Chamber are always really a waste of time.

Justine Greening: I am grateful for that, Mr. Deputy Speaker. However, I have to say that issues have been raised about the commitment of my hon. Friend the Member for Henley (Mr. Johnson); apparently, that does not cut both ways.  [Interruption.] Well, I could ask where the hon. Member for Battersea (Martin Linton) is. What I am saying is that we can all make such points.
	Crime is an issue for my constituency. When I conducted a crime survey, more than 3,000 people responded. They largely said that they felt as if their local area was getting less safe. They raised issues of antisocial behaviour, being mugged, their children being mugged and crime on transport. My constituents want those issues to be tackled because they do not feel that they are being so at the moment.
	Nor do they feel that the money that they are paying as part of the mayoral precept is giving them any sort of return in terms of policing per pound. In the eight-year period of the London mayoralty, my constituents have paid £66 million more than before into the Met police precept. We have not had any sort of return on the money that we have invested. Frankly, we would rather have spent the money locally and had more police, who can arrest people on our streets, to complement the PCSOs. That has not happened. Most of my constituents want a Mayor who will genuinely try to make the city safer instead of living by headlines. We want a Mayor who will seriously tackle youth crime, about which parents in my constituency worry every day.
	I shall finish by citing one statistic. In recent years, about one in 20 secondary-school-aged children who live in Wandsworth reported having been a victim of mugging. That statistic is surely unacceptable to any of us in this House, whichever side we sit on. If we can at least agree on one thing, it is that crime is too high and that we need to bear down on it by spending our money smartly so that communities such as my own can feel safer.

Andrew Slaughter: I will use the little time that I have to express my disdain at the motivation of the Conservatives in their conduct of this debate. It is a perfect example of calling a debate to obscure and confuse the issue under discussion.
	I am grateful to my hon. Friend the Minister for laying to rest some of the bogus facts that have been put forward about the undeniable fall in crime of 20 per cent. over the past five years and the record numbers of police—35,000, with a further 1,000 promised. The double standards of the Conservatives show that they are confused and in denial. As my hon. Friend the Member for Eltham (Clive Efford) said, they claim credit locally for falls in crime but, on a London basis, claim that crime has not fallen. They oppose the investment that has gone in. We just heard the hon. Member for Putney (Justine Greening) say that she does not believe that anything has changed in London and that community policing is exactly what it was previously, but we know that there has been huge investment and that that is connected to what has happened to crime rates.
	I am afraid that the hon. Member for Putney and my hon. Friend the Member for Eltham know less about the situation in Hammersmith and Fulham than I do because I am the only MP here from that borough. In reality, the money for the police officers who were put into the ward, as mentioned by my hon. Friend, was taken out of another ward that had even higher crime, the reason being that, under the Labour council, those officers had been paid for by the council, but the Conservatives have moved them into wards that receive Government funding through the new deal for communities or section 106 moneys. Once again, they are using statistics and money to manipulate figures in a way that can disadvantage people locally.
	I agree with my hon. Friend the Member for Eltham that if this debate is about reviving a flagging campaign, it certainly has not worked. I would say in defence of the hon. Member for Henley (Mr. Johnson) that perhaps the reason why he walked out of the Chamber was that he was listening to his own policies being recited by Conservative Front Benchers. When one compares 1,000 extra police officers with being given maps or ending accountable stop and search, I am not surprised that he decided to leave the Chamber.
	When people vote in London next Thursday, they will vote on the issue of crime, and they will make a decision primarily about whether Ken Livingstone or the hon. Member for Henley is in a better position to deal with that. They will see on the one hand somebody who has a track record of investing in and reducing crime and on the other somebody who is not fit to take over that role—somebody whose own record does not allow him to take over that role. I refer in particular to the disgraceful episode that is documented on tape, where the hon. Member for Henley agreed to give details of a journalist to someone who became a convicted fraudster, on the basis that he was an old school friend of his, in order to allow that journalist to be beaten up. Somebody who is prepared to do that— [ Interruption. ] I can quote the details if hon. Members want. The only things in that conversation—

Mr. Deputy Speaker: Order. The hon. Gentleman has made a very serious charge.  [ Interruption. ] Order. In this House, we ought to debate matters in a calm way. I am not sure that the proximity of elections of whatever kind helps to enhance the reputation of the House. It would help if the hon. Gentleman said that he would put those words aside; he has already put them on the record in a way. It does not help when we have the kind of exchanges that have been going on this afternoon.

Andrew Slaughter: I entirely accept what you say, Mr. Deputy Speaker. I do, however, have the transcript of that conversation in front of me, and I am prepared to make it available to any other hon. Members, who can make their own judgment about it. I simply say that I do not believe that the hon. Member for Henley is a person Londoners would trust to run policing because of his own personal record as dictated in that phone conversation.

Bob Neill: I shall be very brief and not go down the route taken by the hon. Member for Ealing, Acton and Shepherd's Bush (Mr. Slaughter). I think that the tetchiness that we have seen from Labour Members indicates that a raw nerve has been struck and that our points have hit home.
	I do not seek to talk London down or to denigrate good work that is done in London. However, I want to know, as do all of us who have constituents in London, how we can make things better and why, against this background, London's great competitor city of New York has done better at dealing with crime than we have and is now safer than London. I have two key points to make on that.
	First, I went to New York recently and spoke to a precinct captain in the Red Hook district of Brooklyn—a tough area. He made the point that the political commitment of Mayor Giuliani and Mayor Bloomberg was a key factor in giving the drive necessary to support police officers and the community as a whole in tackling crime.
	Secondly, the specific technical advantages of the CompStat system and crime mapping had given the police and the community the material that they needed to work together to tackle crime in one of the hardest parts of New York. I am sorry that that proposal from my hon. Friend the Member for Henley (Mr. Johnson) has been so airily dismissed by Labour Members. London deserves better than that. It is a serious proposal, accepted by serious people tackling crime in another city. I would have hoped that we were broad-minded enough to work together and take that on board. I would have thought that we all wanted to do justice to the tackling of crime in this city in such a constructive spirit. I am sorry that that has not always been achieved in this debate.

James Brokenshire: It is a pleasure to follow my hon. Friend the Member for Bromley and Chislehurst (Robert Neill), who made an important point in his comparison of London and New York.
	I join other hon. Members in paying tribute to the work of all police officers in the capital in their daily fight against crime. The Metropolitan police, the City of London police and the British Transport police all work hard on our behalf to secure the protection of everyone who lives and works in the capital. It is right that we should recognise their service, commitment and dedication to duty. But the inescapable fact highlighted by the debate is that the Labour Mayor and the Labour Government are letting London down on crime. Violence against the person is up, with over 3,300 crimes committed each week. Drug offences, with their links to organised crime and gang violence, have increased by an astonishing 200 per cent. since the Mayor came to office, and nearly half of Londoners say that they simply do not feel safe in their communities at night. If that is a measure of success it shows just how out of touch the Government and the Mayor are with reality and with real Londoners.
	The hon. Member for Carshalton and Wallington (Tom Brake) made some important points about gun and knife crime and the serious issues that arise from it. The hon. Member for Regent's Park and Kensington, North (Ms Buck) brought those issues home in her description of the tragic deaths of her constituents. I am sure that the whole House wishes to pass on its condolences to the families of those involved in those terrible incidents. The hon. Member for Eltham (Clive Efford) sounded at times as if he were reading from the telephone directory, rather than reading a speech. Instead of lecturing my party about the stop-and-account form, he should look at the Flanagan review, commissioned by his own Government, which recommended that the form be abolished.
	My hon. Friend the Member for Ilford, North (Mr. Scott) made some important points about the way in which local initiatives can make a difference, and about how, in Redbridge, locally funded street wardens are helping to deal with antisocial behaviour in his constituency. That point about local community action and how it can make a difference was also raised by my hon. Friend the Member for Putney (Justine Greening).
	Sadly, I have to say to the hon. Member for Ealing, Acton and Shepherd's Bush (Mr. Slaughter) that he does himself no favours by making personal smear attacks. There are very serious issues to be debated, and rather than this party being confused or being in denial on those issues, I suggest that his criticisms should be directed to his party and the Mayor.
	Many hon. Members have highlighted the shocking number of teenagers killed on London's streets in the last year: 27 teenagers were murdered, with 11 murders of young people in 2008 already. One of the most disturbing trends is that both the victims of these crimes and those suspected of carrying out the offences are getting younger. Analysis from Trident has shown that in certain cases the age of those involved is as low as 14, with more teenagers being charged for murders and shootings. I have spoken previously about the organised gang culture, supported by the trade in class A drugs, that lies behind a significant proportion of these crimes.
	One of the most insidious aspects of the organised criminal gang structure is the conscious focus of those who recruit new gang members on some of the most vulnerable in society—those with poor educational attainment and weak family support structures, and those who suffer from addiction, mental illness and unemployment. They are targeted to deal drugs to give them an income. That is why the utter failure to control drug crime in the capital is so serious and why simply giving out more cautions for drug offences—with the number doubling in the past two years—sends out the wrong message.
	Other fundamentally wrong messages are being conveyed. I stress to the Minister in the starkest terms that police trying to negotiate with the gangs, as some recent statements from the Metropolitan police suggest, is not the solution. We need strengthened communities and families, and visible and robust policing. We also need to tackle the underlying problems of addiction.
	The Government have opted simply to maintain addiction rather than lift people out of it, with London's bill for methadone prescriptions running at £2.5 million a year.
	We need proper, abstinence-based rehabilitation for offenders, not a slap on the wrist and a prescription for the pharmacist. The police also need effective tools—that is why we believe that it is right to revise the current powers of stop and search to give police sergeants, who are at the heart of safer neighbourhood teams in their communities, the right to authorise general stops and searches in a designated area, where weapons are thought to be present or crimes of violence are thought to be about to occur, for a period of up to six hours.
	However, the problem is not only the most serious offences, but the everyday experiences of Londoners on their streets, in their communities and even in their homes.
	For too many, the impact of antisocial behaviour and what some describe as "low level" crime is significant. There is nothing low level about the impact of antisocial behaviour on people's quality of life. For many, especially the elderly or vulnerable, their street, shops or neighbourhoods do not feel safe. That picture is reflected in the opinion surveys of London residents and hardly alleviated by the comments of the Home Secretary or the actions of the Leader of the House.
	However, young people are more likely to feel the effects of antisocial behaviour and crime. Around a third of all street robberies are committed against the under-16s. Some Labour Members have rightly highlighted the number of young people who are mugged in London. It is absurd that the Government continue to drag their feet in recognising crimes against the under-16s in the British crime survey. As we have heard, such offences often occur on the buses, the tube and other forms of public transport, with mobile phones, iPods and other valuables being stolen.
	My hon. Friend the Member for Henley (Mr. Johnson) rightly identified a more visible police presence, the use of real-time CCTV and tougher measures to tackle fare evasion and the abuse of the transport system as important measures to restore public confidence.
	The Government have completely lost their way in cracking down on antisocial behaviour. Their rigid, centralised, bureaucratic command and control structures have driven the police in the wrong direction, chasing meaningless targets for "bringing crimes to justice", involving issuing penalty notices like glorified parking tickets. In 2006, nearly 21,000 penalty notices were issued in the capital—yet only four out of 10 were paid in full. It is difficult to identify the "justice" in that.
	Even the Metropolitan Police Commissioner, Sir Ian Blair, has hit out at the system that has grown up around him. Yet neither the Government nor the Mayor has acted on that. So much for the bonfire of the regulations, for which the Metropolitan Police Commissioner called. That is why my hon. Friend the Member for Henley is absolutely right to identify the need to scrap the unnecessary stop form, freeing around 160,000 hours, which the police could spend on the beat, protecting Londoners and catching criminals.
	The Government's supposed measures to improve community safety have made things worse, not better. London's A and E departments are feeling the strain from the impact of the Government's 24-hour drinking laws. Since the introduction of those changes, London hospital casualty admissions for alcohol-related problems have increased by a third. That highlights how cavalierly the Government introduced 24-hour licensing. But since 2000 the police precept has increased by around £400 million—an increase for the taxpayer of 150 per cent. per person. That is why we need to give Londoners proper details of police performance in their areas, through effective crime mapping in their neighbourhoods. That way, communities can play a more active part in holding the police to account.
	The real question, however, is how committed the Government are to neighbourhood policing. As we have heard, the Flanagan review states that the current police numbers are "unsustainable". The Government have welcomed the report, so presumably they welcome the cuts in police numbers that it underlines. The clear message is that police numbers are at risk. Violent crime in London is up, while drug crime has rocketed under Labour. Londoners deserve better than the tired offerings of a tired Mayor and a tired Government. It is time for a change. It is time for concerted action to make this city a safer place. It is time for a Conservative Mayor of London.

Vernon Coaker: I thank all hon. Members who have taken part in this debate. I would have welcomed a contribution from the hon. Member for Henley (Mr. Johnson), who was no doubt the reason it was called, but he managed to turn up for only 40 minutes of it.
	I thank my hon. Friends the Members for Eltham (Clive Efford), for Regent's Park and Kensington, North (Ms Buck) and for Ealing, Acton and Shepherd's Bush (Mr. Slaughter), who all spoke in the debate, and all my hon. Friends who asked questions. I should also point out that although my hon. Friend the Member for Tooting (Mr. Khan) has been here for much of the debate, he is unable to speak in debates as a Government Whip.
	The points that all my hon. Friends made stood in stark contrast to the two contributions that we heard from the Opposition Front Bench. That marks the difference in what this debate is about. All that we heard from the Opposition Front Bench was a story about the real issues of crime in London. We heard no reflection at all on the statistics with which the Metropolitan Police Service has provided us. Instead, we heard an attempt to whip up fear about crime and to portray London as a city where there are people roaming every street who will attack anybody at a moment's notice. That was the picture that Opposition Members were trying to portray. My hon. Friends pointed out, as I will point out in a moment, what the Metropolitan Police Service's statistics actually say. Of course there are challenges, but let us try to move forward on the basis of facts, not spurious exhortations to the public to believe that we are all doomed.

Keith Vaz: On the issue of facts, when Sir Ronnie Flanagan gave evidence to the Select Committee on Home Affairs, he did not talk about a reduction in police numbers. He welcomed the resources that the Government had given over the past 10 years and talked about the more efficient use of resources. The hon. Member for Hornchurch (James Brokenshire) is wrong to misquote Sir Ronnie as he did.

Vernon Coaker: My right hon. Friend puts the issue well. Let me read out some facts, so that we can get them on the record. Police numbers in London are at record levels. Since 2000, there has been an increase of more than 10,000, which has been made possible by the Government's and the Mayor of London's investment. The figure of 35,000 is made up of more than 31,000 police officers and more than 4,000 PCSOs. The Mayor's budget for 2008-09 includes an additional 1,000 police officers. Let me also put it on the record that those are the figures from the Metropolitan Police Service. They are the figures that the Opposition seemed to traduce, when they said that there were not real figures or figures to be trusted. I will tell you what, Mr. Deputy Speaker, if I am going to trust any figures, I am going to trust the Metropolitan Police Service's figures on recorded crime.
	It was interesting that the hon. Member for Bury St. Edmunds (Mr. Ruffley) would not go back to 2002-03, but used 1998-99 as his baseline. The reason is that there was a different way of counting crime in 1998-99. Let me go through the figures, just as the Metropolitan Police Service has, from 2002-03 to this year, which are all counted in exactly the same way, so that the people of London know exactly what is happening. Between 2002-03 and this year, there was a more than 20 per cent. reduction in crime. There has been a reduction in the total number of murders in London since 2002-03 of 17.5 per cent, and a reduction in the total number of knife-enabled offences of more than 30 per cent. during that period. The year-on-year figures from the Metropolitan Police Service also show considerable reductions in crime. We need to ensure that the people of London know about these reductions, not because we want to be complacent or because the job is done, but because we want to move forward on the basis of facts.
	My hon. Friend the Member for Eltham took great delight in reading out what Tory-controlled authorities in London were saying about crime in their local newsletters and on their websites, and I do not blame him for doing so. What they are saying is totally at odds with what those on the Opposition Front Bench have suggested. Let me defend some of those Tory borough councils in London for what they have said about crime. Tory-controlled Barnet council says that it has seen a 17.5 per cent. reduction in crime, while Enfield council's website states:
	"The number of offences in Enfield has fallen by nearly 10 per cent."
	Many other Tory-controlled authorities right across the city are congratulating themselves on falls in crime and telling their residents about them. That is completely at odds with the picture that the Tory mayoral candidate and the Opposition Front-Bench spokespeople are trying to paint.
	Why have we seen this reduction in crime? Why have we seen such an increase in confidence among people in London in this regard? It is partly a result of the introduction of the safer neighbourhood teams, which were introduced with the wholehearted support of the Mayor. Indeed, with his support, they were introduced a year earlier in London than in much of the rest of the country. We now have visible, accessible, responsive policing on our streets in all 600 wards in London. Let us also be clear that a key part of the safer neighbourhood teams in each and every ward is played by the police community support officers, whose introduction was opposed by the Conservatives, including the hon. Member for Henley.
	Alongside the safer neighbourhood teams, we need to see tough enforcement of the law, and we have indeed seen special police operations taking place alongside the work of the teams. Let us also remember that tough enforcement of the law includes tough sentencing. One of the toughest sentences that the people of London support is the minimum sentence for the possession of unauthorised firearms, which was also opposed by the hon. Member for Henley.
	While we are talking about the need for tough enforcement, let us also reflect on what contributes to the reduction in crime, and on what makes a difference. Alongside the tough enforcement approach and the safer neighbourhood teams comes partnership and prevention. If we are to continue to reduce crime and to tackle gun and knife crime, we also need to invest in youth services and the partnerships involved in them. The Mayor of London has led the way in supporting initiatives across the city to prevent young people in particular from becoming involved in crime. He has been particularly involved in trying to divert young people away from crime in the first place. With the Government, he has set up a new £75 million youth offer, which will make a considerable difference in tackling these issues in our communities across London. It will give support to the parents and young people who need it, and it will develop the services that are so important if we are to continue to bear down on—

Patrick McLoughlin: rose in his place and claimed to move, That the Question be now put.
	 Question, That the Question be now put,  put and agreed to.

Question put accordingly, That the original words stand part of the Question:—
	 The House divided: Ayes 193, Noes 308.

Question accordingly negatived.
	 Question, That the proposed words be there added,  put forthwith, pursuant to Standing Order No. 31 (Questions on amendments):—
	 The House divided: Ayes 303, Noes 181.

Question accordingly agreed to.
	Mr. Deputy Speaker  forthwith declared the main Question, as amended, to be agreed to.
	 Resolved,
	That this House recognises the commitment and enthusiasm of the police officers of the Metropolitan Police Service, the City of London Police and the British Transport Police and further recognises the valuable contribution made by police community support officers and police staff to cutting crime in London; notes that police numbers in London now stand at record levels; welcomes the aim of the Mayor of London to add 1,000 more as part of his clear commitment to making London one of the world's safest capital cities; supports the introduction of Neighbourhood Policing Teams in all 600 wards in London to give communities greater access to policing in their areas; praises the work of the Metropolitan Police Service, which enjoys high levels of public satisfaction; further recognises the success of its enforcement operations and actions to tackle violent crime which have led to major reductions in gun and knife crime; acknowledges the importance of community and faith organisations in helping to make communities safer; welcomes the significant falls in overall recorded crime in London; and notes that homicide levels in London are at their lowest for nine years.

EUROPEAN UNION DOCUMENTS

Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Committees),

Reduction of Greenhouse Gas Emissions by 2020 and Review of the Emissions Trading Scheme

That this House takes note of European Union Documents No. 5849/08 and Addendum 1, Draft Decision on the effort of Member States to reduce their greenhouse gas emissions to meet the Community's greenhouse gas emission reduction commitments up to 2020 and No. 5862/08 and Addenda 1 to 3, Draft Directive amending Directive 2003/87/EC so as to improve and extend the greenhouse gas emission allowance trading system in the Community; and supports the Government's aim of contributing positively towards the negotiation of both instruments to maintain the ambition of the Commission's legislative package and the strong EU leadership in tackling climate change and putting the EU on track to become a low-carbon economy.— [Liz Blackman.]
	 Question agreed to.

DRAFT CONSTITUTIONAL RENEWAL BILL (JOINT COMMITTEE)

Resolved,
	That this House concurs with the Lords Message of 20th March, that it is expedient that a Joint Committee of Lords and Commons be appointed to consider and report on any draft Constitutional Renewal Bill presented to both Houses.
	 Ordered,
	That a Select Committee of eleven Members be appointed to join with the Committee appointed by the Lords to consider the draft Constitutional Renewal Bill (Cm. 7342).
	That the Committee should report on the draft Bill by 17th July 2008.
	That the Committee shall have power—
	(i) to send for persons, papers and records;
	(ii) to sit notwithstanding any adjournment of the House;
	(iii) to report from time to time;
	(iv) to appoint specialist advisers; and
	(v) to adjourn from place to place within the United Kingdom.
	That Mr Alistair Carmichael, Mr Geoffrey Cox, Michael Jabez Foster, Mark Lazarowicz, Martin Linton, Ian Lucas, Fiona Mactaggart, Mr Virendra Sharma, Emily Thornberry, Mr Andrew Tyrie and Sir George Young be members of the Committee.— [Liz Blackman.]

Hon. Members: Object.

Public Family Law

Motion made, and Question proposed, That this House do now adjourn. —[Liz Blackman.]

John Hemming: I should like to thank Mr. Speaker for agreeing to the subject of this Adjournment debate.
	I should start by declaring that in 2006 I brought together a number of campaign groups in the justice for families campaign, which I chair. I am also taking the unusual step of releasing a campaign song, the proceeds of which will be used to prevent miscarriages of justice.
	There is something rather dreadful happening in England today, but not in Scotland. In England, we have targets for adoption and rewards for moving children from one family to another, but not in Scotland, where the priority is to keep families together. In England, two thirds of children leaving care are adopted, but not in Scotland, where two thirds of children under five go home to their birth parents. The drive to increase the number of adoptions and the recycling rewards for local authorities have caused masses of miscarriages of justice. Yvonne Coulter, Chris Smith, PC and S and the Websters were all cases in which children were stolen by the state from their birth parents, only for it to be found later that it was a mistake. A mistake, yes, but not a mistake that can be put right.
	I know of a case in which a baby was put into care on a fast track to adoption because his mother might get post-natal depression. Is that right? I do not think so. How did it help the local authority? It helped it hit its recycling target. In the deep, dark corners of the British legal system, hidden away by threats of imprisonment for those who speak out about injustice, we have allowed bad practice to fester. No action can be taken by a Member of Parliament to prevent solicitors from undermining their own clients because they want to keep the money coming in from the local council. No action can be taken by an MP to stop social workers who lie to the courts because they want to win a case and hit their adoption targets, or to stop doctors who provide rubbishy, unproven and unchallenged medical evidence that destroys families, but fills their bank accounts.
	The reason for that is the secrecy of the proceedings under the Access to Justice Act 1999. There are a number of very good people working in the system to protect children from maltreatment, but they are undermined by the lack of action to deal with bad behaviour by practitioners. That has to come to an end. We need to consider the issues honestly and openly while we have an opportunity to amend the Children and Young Persons Bill. I have two new clauses that could assist in improving accountability without undermining children.
	As in all aspects of the public or private sector, there is a range of people of different competences. There are some very good people working as social workers, lawyers, experts or judges, but there are also those who are incompetent or corrupt. The difference in public family law is that the secrecy of the system prevents accountability. In theory, there are checks and balances that prevent the abuse of state power, but practitioners often collude to prevent those checks and balances from coming into operation.
	A good current example is a case covered in the following verse in the song I referred to earlier:
	"The boys they say that they won't talk to their mom
	The judge says foster care is what must be done
	Dad says its wrong by writing a book
	He's put in jail 'cos somebody looked."
	It is absolutely absurd to place two children aged 13 and 15 in foster care because they will not talk to their mother, who is estranged from their father. The father would like to appeal, but the lawyers, including his own solicitor, are working against him. To appeal, he needs a judgment, but he still has not been given it. On Monday, I spoke to the 15-year-old, who is in fact 16 today, and he said, "I think children's social services are a complete disaster. My brother is mortified because he wants to go back to his dad. I think the way things are happening is pathetic. My father has never hurt either of us."
	Let us understand the reality of this. Tens of thousands of pounds are being spent to keep in care two children who have never been hurt by their father. In effect, they are being imprisoned in care for no good reason. However, outside Parliament, we are not allowed to scrutinise the reasoning. The problem is that the rule of law is systematically undermined in the family division.
	There is supposed to be a tape recording of the hearing. However, as yet, we have not managed to obtain a copy of such tapes. Transcripts are refused to parties on the basis of exaggerated costs. In the Harkness case, the transcript did not correlate with the parents' memory of the case. In Pauline Goodwin's case, the tape of her hearing in the Court of Appeal seems to have gone astray. If somebody manages to get a case to the Court of Appeal, the court has been known to say that it is out of time even though somebody has been struggling for years for a judgment.
	One of the more worrying aspects about the Court of Appeal is that substantive cases are heard at the permission stage. If the court decides to refuse the appeal, it makes an order under section 54(4) of the Access to Justice Act 1999, preventing the case from going to the House of Lords. The Act prevents family law decisions from being considered by the House of Lords to ensure that we have a unified body of law. We have to ensure that parties are provided with tapes of their hearings immediately afterwards so that they can obtain timely copies of the judgments. We also need to change section 54(4) of the 1999 Act so that there is proper consideration of issues by the UK supreme court, the House of Lords.
	It is worth considering a few cases in some detail to see how things go wrong. Fran Lyon's case never encountered the courts. She was a pregnant mother who became one of my constituents for a while before she emigrated. She was told that she was such a great risk to her baby that the child had to be removed within 15 minutes of birth and she could never breast-feed. However, her case was reviewed in Sweden. All the information cooked up by children's services and doctors in Northumberland was examined and it was decided to discharge her from hospital. Fran suffers from angiodaema so she has a tracheotomy. The doctors in the north-east said she had Munchhausen syndrome by proxy and caused her angiodaema herself. The doctors in Sweden said that she should sue the doctors in the north-east for malpractice because her angiodaema was not self-induced—it even occurred when she was unconscious. Yesterday, I received the official English translation of the Swedish social work report, which concluded:
	"Our assessment is that there is no need for support or any other programme with regard to Fran's capacity as a parent."
	In England, the plan was to take the baby 15 minutes after birth, which would have also involved the usual twin-tracking adoption plan. In Northumberland, there was systematic and corrupt abuse of process. Sadly, that is all too common in the system.
	In Norfolk, in the Webster case, the health visitor was pressurised to change her opinion about the family. When combined with unreliable and wrong medical evidence, that caused three of the children to be adopted. Another case in Norfolk involved three social workers in a 12-person case conference deciding to override the nine-three vote that a child was not at risk. Instead, they put the child on the child protection register. All 12 experts got together. Nine voted that there was no problem, but three voted that there was and later decided to ignore the nine. That is abuse of process. It is not democratic and it is not a proper mechanism. I am aware of other sub judice cases in Norfolk, on which of course I cannot comment. They all involve abuse of process and perversion of the course of justice.
	Although the targets and financial rewards for adoptions have now rightly been scrapped, their presence has massively damaged an already creaking system. While they were in place, in law the opinion of the local authority was subject to a financial conflict of interest, which made a substantial number of judgments unlawful. The lawyers like to blame the social workers. However, the real problem lies in the court system and the law.
	The test for almost any decision making is whether there is a "risk of significant harm"—the standard section 31 definition in the Children Act 1989. The vagueness of that description allows all sorts of nonsense to be accepted. At the same time many parents' solicitors are subjected to a conflict of interest because they are also paid by the local authority or guardian. It is sadly not rare for a parent's solicitor to fail to contest an application for a care order, or indeed to persuade parents, against their will, to accept that the section 31 threshold has been met. At that point the parents are at the mercy of the state's family steamroller.
	In the meantime, the children are almost invariably ignored. I referred to the case of children who did not want to be in care; they are being ignored by their guardian. Someone is appointed whose job title is "representing the interests of the children"—the guardian ad litem. Most of those guardians work for CAFCASS—the Children and Family Court Advisory and Support Service. CAFCASS East Midlands was recently inspected by Ofsted, who found the service "inadequate"; in other words, not up to the job.
	Historically, the judges have had a tendency merely to agree with the proposals of the local authority, unless the guardian takes a different view; we therefore have a system that depends on a financially biased local authority and a frequently inadequate guardian—not a recipe for good decision making. That meant that parents did not have a prayer. Things have improved more recently, and that should soon become evident from the statistics on cases. There are still problems following the new public law outline, but most of the cases in which there are problems are still sub judice, so I shall not refer to them.
	What are the Government doing? Recently, the case of Simeon Kellman came before the criminal courts. He used a council's child database to find victims to abuse. The Government are to introduce a national database, so that the Kellmans of this world can find their victims nationally—very clever. We know that being in care is not good for children, so why are children put into care for rubbishy reasons?
	Another problem is that we really do not know what happens to children who go through the system. One local authority lost 61 children in one year; it has no idea where they have gone. There is an annual return called the SSDA903 that is sent to the Department for Children, Schools and Families. That return does not track the point at which children come out of care, unless they are adopted or go into special guardianship. It does not track most outcomes; it gives them as "other". When one asks people to go through the files, as we did in the case of the authority where 61 children were lost, they say that they can find some of the children, but one local authority—admittedly a rather large one—does not know where 61 kids went. In Scotland, authorities do look at where children end up. That is why it is easier there to find out what is happening to the children.
	We have been running a massive social experiment in forced adoption—adoption against the will of not just the parents, but those children old enough to understand what is happening. A study conducted by Ofsted looked at children's views of the adoption process. At least a third said that they did not want to be adopted; they wanted to be left where they were. Inevitably, a large number of forced adoptions break down, but there is little research on the subject. I recently had discussions with the National Society for the Prevention of Cruelty to Children about the process of forced adoption and how it affects children in the long term. Figures indicate that the failure rate of forced adoptions is, at a minimum, a quarter to a third. That is the sort of information on which we should get proper research, but that research is not being done.
	Another appalling aspect of the system is the way in which children are damaged by care proceedings, even if the proceedings end with the children going home. Let us take a situation where a baby is taken away at birth and put into foster care—that is not good for the baby, to start with. After about a year's legal wrangling, when people have made lots of money from representing various parties, the child goes home because it is found that there was no evidence of any risk in the first instance. Think about the Fran Lyon case; what would have happened to her if she had stayed in England? She would have lost her baby at birth and there would have been massive wrangling. In fact, her first lawyer told her that she should just give up because she would never win, so she emigrated. It damages children to go through that process. The fact that the system tends not to let go means that children get damaged by the process.
	A case in Oldham—the judgment was anonymous, which is very good—caused a mother to have an abortion to avoid care proceedings. In that case, a child was taken away at an early stage because of allegations that the child had been harmed by the parents. After massive legal and medical wrangling, and an attempt to get a second opinion—the opinion was initially refused by the court of first instance and by the court of appeal, but then accepted by the court of appeal—the parents were proved innocent. They were not just not guilty; it was proved that it was not a shaken-baby-syndrome-type case, for those who study these things. There was no justification for the intervention whatever, but the child and the parents suffered, and the mother had an abortion to prevent the same thing from happening to another child.
	We really need to carry out proper, rational risk analysis. The intervention of the state is almost invariably damaging. We need to minimise the damage caused by intervening while any investigation is going on. Most foster carers are good people, but we have to stop covering up situations where foster carers abuse the children in their care. The Care Leavers Association wants a public inquiry on the issue, and we should accede to its demand. We also need to revisit the idea of supporting families, rather than using the hammer.
	The system is far more badly broken than I expected it to be when I started studying it. The way in which the child protection system operates has wide ramifications for society. The evidence is clear in the number of prisoners who have been in care. It is also clear that the removal of children from mothers who are victims of domestic violence is causing them not to report that violence. The procedures followed after multi-agency risk assessment conferences, which are carried out in response to 392 forms, are causing concern among mothers who are victims. People suffer in silence rather than having to handle the consequences of asking for help.
	We cannot continue leaving the details to the practitioners. Proper scrutiny and accountability are essential. The system is supposed to have as a priority keeping families together. Why, then, are they split up in England, but kept together in Scotland? The Prime Minister said that the difference came from a difference in social work practice. Clearly, the system does not do what it says on the box. It does not protect children properly or support keeping families together properly. The evidence is there, north of the border.
	We have systematically excluded grandparents from the decision-making process. That is ludicrous, as they are the normal source of back-up child care. Early-day motion 1199, which I tabled, focuses on the issue, following suggestions from the GrandParents Association and various other lobby groups. I am pleased to say that a motion has been tabled at the Council of Europe leading towards an investigation into family law in England and Wales. It would be good if we could have such an investigation in this country and not rely on the Council of Europe to sort out our problems.
	Yesterday, we heard of the number of families destroyed by the system, often for no reason other than financial reward. Today we must start debating the issues, and tomorrow we need to reform public family law and stop such things ever happening again.

Bridget Prentice: I congratulate the hon. Member for Birmingham, Yardley (John Hemming) on securing a debate on an issue that is important to everyone in the House and outside—an issue that we should examine with care and consideration. Instead of ranting, we should take a comprehensive, considered and objective view of what we can do to make life better for those who are among the most vulnerable in our society. I am pleased, therefore, to have the opportunity to speak about the proceedings for children and to reiterate and emphasise the Government's commitment to helping and supporting vulnerable children.
	Fortunately, the number of children in need in this country is relatively low compared to the total number of children in the country, but that does not mean that we should be or are any less committed to addressing those children's problems. We take our responsibilities in that regard extremely seriously. I shall summarise the recent background to the way we deal with matters relating to children and young people. In 2003, we published the "Every Child Matters" Green Paper, which set out five outcomes that we want to see achieved for all children. It is worth remembering that one of those outcomes was that children should be protected from harm and neglect so that they stay safe.
	Things have not stood still since 2003. The Children Act 2004 put in place new structures to help us deliver those five outcomes. Also in 2004 we published "Every Child Matters: Change for Children", which set out a continuing national programme of change, outlining how the reforms were to be implemented. At the heart of that programme was the goal of ensuring that all children, especially the most vulnerable, are able to stay safe. I agree with the hon. Gentleman in one respect. Our starting point is that state intervention is and must always be a last resort. We firmly believe that children should live with their parents, provided it is safe, and that, where necessary, families should be given extra support to help them stay together.
	On 1 April this year, I made a written statement to the House detailing two key reforms to the wider care proceedings system, which came into force on that day. The first of those was the revised Children Act statutory guidance to local authorities, issued by my colleagues in the Department for Children, Schools and Families and the Welsh Executive. It underlined to local authorities the need for them to work more closely with families and others to find alternative solutions to entering legal proceedings at all, always, of course, on the basis that it is safe to do so.
	The guidance stressed that local authorities must explore all safe and suitable alternatives. Those should include targeted support for parents to enable children to remain at home and, another option that is hugely important in our diverse society, the possibility of the child being cared for within the wider family, whether by grandparents, aunts, uncles or even older siblings.
	Of course, that was already a requirement in the Children Act 1989, but it was re-emphasised, and I hope will be continually re-emphasised, under the guidance published a few weeks ago. That said, where the local authority has immediate concerns about safety, they are able to apply for an emergency protection order or to make an immediate application in care proceedings. We know—something to which the hon. Gentleman referred—that the longer-term prospects for children who remain with their extended birth family where it is established that it is safe, can be much better than for children who are in care.
	At the same time in April, a second reform, the public law outline, also came into effect. This is a new judicial case management tool that dovetails precisely with the statutory guidance. It provides a more streamlined procedure for the way in which courts handle care applications, so that cases can be resolved more rapidly when a local authority decides that the only safe solution is to seek an order through the court.
	The outline makes it clear to local authorities what the courts expect of them. Local authorities will have to demonstrate to the court that they have thoroughly explored all suitable and safe alternatives. They will also have to show the court what steps they have taken to work with families to try to enable the child to remain within his family home or within the wider family. In that way, the outline will, to all intents and purposes, provide an additional check on the actions of local authorities that issue proceedings.
	I want to share with the House some of the things that were said at the formal launch of those reforms on 1 April. I sat and listened to the three representatives of the Children and Family Court Advisory and Support Service young people's board who talked more eloquently than any politician or professional about their hopes and aspirations for the way in which the reforms will impact on their lives.
	One of them said:
	"You will be working with us as active partners in our own case...listening to us, understanding us, moving at our own pace...sometimes faster, sometimes slower."
	So I take issue with the hon. Gentleman when he says that we are not listening to what young people have to say. He will know that I have a particular interest in ensuring that young people's voices are heard in this place in terms of extending our democracy, and in terms of those who are vulnerable and who need the state's systems to protect them.
	Another of the young people said, "Sise does matter." Sise is: see us, inform us, support us, empower us. It is true that in the past it has been all to easy sometimes to forget that what we do, we do to protect children, and that children's voices can often be swamped in the adult noise. Of course the Children Act underlined that when it said that the welfare of the child must be paramount in the decisions of the court. I believe that the Children Act strikes the right balance; a balance between the complex set of rights and responsibilities, the rights of a child to be safe from harm, and the responsibilities of parents. It also makes it clear that the state has a duty to intervene, when a child's welfare demands it.
	We have introduced the Children and Young Persons Bill, which is a key part of our agenda to improve outcomes for children in care. Our aspirations for children in care must be as high as those for our own children. We must ensure stability in every aspect of care, and there must be good parenting from all those working with children in care, in the same way as we work on improving parenting for those children who remain with their families. There must also be a stronger individual and collective voice for every child in care. The Bill will provide the legislative base to deliver many of the changes set out in the White Paper, "Care Matters: Transforming the Lives of Children and Young People in Care", to make that vision a reality.
	The hon. Gentleman has raised a number of individual cases, although he could not refer to some of them in detail. I do not believe that there is systematic corruption and unprofessionalism throughout the social services, local authorities, the courts or elsewhere. He is being unfair to those who work closely with children who need our help and support, and who ensure that those children receive that help and support. The president of the Association of Directors of Children's Services "flatly rejects" the odious claims surrounding so-called forced adoptions. There is no coherent evidence to support those claims, and the notion that honest, skilled and hard-working professionals would seek to cause children to be adopted unnecessarily is unacceptable. I believe that she holds that view honestly and professionally, and the Government and I support it. Our underlying theme will always be that the welfare of the child is paramount, which is what we seek to achieve.
	 Question put and agreed to.
	 Adjourned accordingly at eight minutes to Eight o'clock.

Deferred Division

immigration

That the draft Immigration (Biometric Registration) (Pilot) Regulations 2008, which were laid before this House on 11th March, be approved.
	 The House divided: Ayes 265, Noes 65.

Question accordingly agreed to.